John Moody, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

023032 Issued in NY

Practice address

3226 Kings Hwy
Brooklyn, NY 11234-2655

Phone

(718) 252-9100

Fax

(718) 252-9401

NPI assigned

Mar 27, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Comprehensive Healthcare Medical PC

  • Specialist
  • Forest Hills, NY
  • NPI 1235456864

  Multi-Specialty

  NPD
• Continental Medical Group

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Rego Park, NY
  • NPI 1710284815

  Multi-Specialty

  NPD (past)
• Med Diagnostic Rehab of South Florida Inc

  • Physical Therapist
  • Lighthouse Point, FL
  • NPI 1184655656
  NPD (past)

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1487159059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3226 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342655",
            "telephone_number": "718-252-9100",
            "fax_number": "718-252-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112342655",
            "telephone_number": "718-252-9100",
            "fax_number": "718-252-9401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21000 NE 28th Ave Ste 104",
            "address_purpose": "LOCATION",
            "city": "Aventura",
            "state": "FL",
            "postal_code": "331801421",
            "country_code": "US",
            "telephone_number": "305-937-1999",
            "fax_number": "786-787-2596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOODY",
        "first_name": "JOHN",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-27",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "PA9111037",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vidya Krish Mony, D.O.
• Juniper Meadowlark Monypenny, MA LCAT ATR-BC
• Christina Monzon
• Shaqcore Moodie
• Tudy-Ann Moodie, RN
• Raymond L. Moody, PH.D.
• Shannon Moody, M.S., CCC-SLP
• Moon Physical Therapy, PC
• Dolly Moon, LCSW
• Jihye Moon

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.