Individual provider Active NPI

Moe Moe Kyi, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1487932612
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A138014 Issued in CA
Practice address
4816 E 3Rd St
Los Angeles, CA 90022-1602
Phone
(323) 780-4510
NPI assigned
Jul 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 44767 AZ
Internal Medicine Physician 207R00000X A138014 CA Primary

Addresses

Primary practice location

4816 E 3Rd St
Los Angeles, CA 90022-1602

Mailing address

950 S Grand Ave FL 2
Los Angeles, CA 90015-3999
Phone (323) 669-4346

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
I20170530001728 CA Practitioner - Internal Medicine 9335315282 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of Los AngelesGroup PAC ID 1850296534, 395 clinicians
Gracelight Community HealthGroup PAC ID 3072619618, 24 clinicians

Practice addresses (Care Compare)

10953 Ramona Blvd
El Monte, CA 91731-2629
Phone (626) 434-2800

150 N Reno St
Los Angeles, CA 90026-4656
Phone (213) 380-7298

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44767AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gracelight Community Health CurrentSince Feb 26, 2017 Accepting new patients
Gracelight Community Health CurrentSince Feb 26, 2017 Accepting new patients

Locations

4816 E 3rd St
Los Angeles, CA 90022
Phone (323) 780-4510

150 N Reno St
Los Angeles, CA 90026
Phone (213) 380-7298

950 S Grand Ave
Fl 2
Los Angeles, CA 90015

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mkyi186669@direct.ochin.org

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1487932612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 S GRAND AVE FL 2",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900153999",
            "telephone_number": "323-669-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221602",
            "telephone_number": "323-780-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYI",
        "first_name": "MOE",
        "middle_name": "MOE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "44767",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A138014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.