Individual provider Active NPI

Kasey Moyer Chanov, PA-C

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1477809952
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C04792 Issued in MD
Practice address
8830 Belair Rd
Baltimore, MD 21236-2401
Phone
(410) 529-9200
NPI assigned
Aug 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C04792 MD Primary

Addresses

Primary practice location

8830 Belair Rd
Baltimore, MD 21236-2401

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other names 1

  • Kasey Marie Moyer Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MDExchange@patientfirstclinics.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140923002087 MD Practitioner - Physician Assistant 2163641176 Reassigns benefits to 1 organization
I20140924000320 DC Practitioner - Physician Assistant 2163641176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10210 Reisterstown Rd
Owings Mills, MD 21117-3606
Phone (410) 902-6776

4924 Campbell Blvd
Suite 125
Baltimore, MD 21236-5921
Phone (443) 461-1997

7116 Ritchie Hwy
Glen Burnie, MD 21061-2904
Phone (443) 577-0277

8830 Belair Rd
Baltimore, MD 21236-2401
Phone (410) 529-9200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C04792MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Maryland Medical Group, PLLC CurrentSince Jul 21, 2014 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Jul 22, 2014 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Jul 21, 2014 Accepting new patients

Locations

8830 Belair Rd
Baltimore, MD 21236
Phone (410) 529-9020

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: mdexchange@patientfirstclinics.com

Organizations & group practices 3

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": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1477809952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8830 BELAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362401",
            "telephone_number": "410-529-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANOV",
        "first_name": "KASEY",
        "middle_name": "MOYER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-02",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C04792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MDExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "8830 Belair Rd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212362401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KASEY",
            "last_name": "MOYER",
            "middle_name": "MARIE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.