Elias Moreno Mandujano, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS20619 Issued in FL

Practice address

2140 Centerville Rd
Tallahassee, FL 32308-4314

Phone

(850) 383-3339

NPI assigned

Jun 13, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elias Moreno Other name

Electronic endpoints 1

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

Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Capital Health Plan, Inc,Group PAC ID 6406744077, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: emoreno21949@tallahasseememorial.direct-ci.com

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.

• Capital Health Plan, Inc,

  • Health Maintenance Organization
  • Tallahassee, FL
  • NPI 1770688566

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1477283679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 HODGES DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 CENTERVILLE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084314",
            "telephone_number": "850-383-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO MANDUJANO",
        "first_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-13",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS20619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elias.morenomandujanodo.p1@direct.capitalhealthplan.nextgenshare.com",
            "affiliation": "N",
            "address_1": "2140 Centerville Rd",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323084314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELIAS",
            "last_name": "MORENO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Elise Nicole Moralez
• Gisela Moran, RN, WCC
• More Ability Therapy Services, LLC
• More Healing Mental Health Care LLC
• Eduardo Daniel Moreno Mandujano, PA
• Morgan Dental Associates, PLLC
• Denise Morgan-Perry
• Susan L. Morgan-Smith, LMT
• Ashlee Elizabeth Miller Morgan, APRN
• Brianna Nicole Morgan

• Family Medicine Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.