Individual provider Active NPI

Hanhey Moon, MD

  • General Practice Physician
  • Bakersfield, CA
National Provider Identifier
1477598910
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A61306 Issued in CA
Practice address
1491 White Lane
Bakersfield, CA 93307
Phone
(661) 835-2600
Fax
(661) 835-2603
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A61306 CA Primary

Addresses

Primary practice location

1491 White Lane
Bakersfield, CA 93307

Mailing address

1491 White Lane
Bakersfield, CA 93307
Phone (661) 835-2600

Other identifiers 1

IdentifierTypeStateIssuer
00A613060MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20051104000281 CA Practitioner - Family Practice 8426076951 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
61306CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
M.a. Medical Group, Inc CurrentSince Jun 2, 2018 Accepting new patients
Maria Auxiliadora Medical Group General Practice Past Accepting new patients

Locations

1900 S Atlantic Blvd
Ste 5
Monterey Park, CA 91754
Phone (323) 728-2885

9401 Long Beach Blvd
South Gate, CA 90280
Phone (323) 567-9782

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1477598910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1491 WHITE LANE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93307",
            "telephone_number": "661-835-2600",
            "fax_number": "661-835-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 WHITE LANE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "93307",
            "telephone_number": "661-835-2600",
            "fax_number": "661-835-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "HANHEY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A61306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A613060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.