Summer Moon, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS14644 Issued in FL

Practice address

115 Highland Ave N
Largo, FL 33770

Phone

(727) 585-8591

Fax

(727) 584-0614

NPI assigned

Jun 12, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Lake Erie College of Osteopathic Medicine, Erie, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bay Dermatology and Cosmetic Surgery P aGroup PAC ID 7517851215, 25 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.95 of 100Reported as group

Quality

78.21

Promoting interoperability

100

Improvement activities

40

Cost

77.18

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: smoon@bayderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bay Dermatology and Cosmetic Surgery P a

  • Dermatology Physician
  • Port Richey, FL
  • NPI 1437148996
  Medicare reassignment Care Compare group NPD
• Christopher G. Nelson, M.D., P.a.

  • Dermatopathology Physician
  • St Petersburg, FL
  • NPI 1407809171
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1457765968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HIGHLAND AVE N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337702530",
            "telephone_number": "727-858-8591",
            "fax_number": "727-584-0614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HIGHLAND AVE N",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "33770",
            "telephone_number": "727-585-8591",
            "fax_number": "727-584-0614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2653 Bruce B Downs Blvd Ste 120A",
            "address_purpose": "LOCATION",
            "city": "Wesley Chapel",
            "state": "FL",
            "postal_code": "335449206",
            "country_code": "US",
            "telephone_number": "813-514-0823",
            "fax_number": "813-406-5167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Highland Ave N",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "33770",
            "country_code": "US",
            "telephone_number": "727-585-8591",
            "fax_number": "727-584-0614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "34941 US 19 N",
            "address_purpose": "LOCATION",
            "city": "Palm Harbor",
            "state": "FL",
            "postal_code": "346841919",
            "country_code": "US",
            "telephone_number": "727-781-7080",
            "fax_number": "727-771-7694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "SUMMER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "5101021452",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "OS14644",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS14644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Lokenberg Montaudo, AUD
• Manuel David Montes, DPM
• Nancy Montgomery, D.M.D
• Tywanna Jaye Montgomery
• Yeny Monzon
• Allison Moore, D.O.
• Mikaella Moore, PT, DPT
• Steven M Moore, M.D.
• Ramiro Morales, DDS
• Meredith B Moran, LMHC

• Dermatology Physician in Largo, FL
• Providers in Largo, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.