Active NPI
Yonny Luis Moreno, SA-C
- Surgical Physician Assistant
- Houston, TX
National Provider Identifier
1497202071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 14-498
- Practice address
- 6560 Fannin St
1610
Houston, TX 77030-2761 - Phone
- (713) 271-2384
- Fax
- (713) 583-2061
- NPI assigned
- Sep 1, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 14-498 | TX | Primary |
Addresses
Primary practice location
6560 Fannin St
1610
Houston, TX 77030-2761
Mailing address
PO Box 3025
Houston, TX 77253-3025
Phone (713) 271-2384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-498 | TX | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Platinum Surgical Management LLC | Surgical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Surgical Physician Assistant
- Houston, TX
- NPI 1316131386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1497202071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3025",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772533025",
"telephone_number": "713-271-2384",
"fax_number": "713-583-2061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6560 FANNIN ST",
"address_2": "1610",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770302761",
"telephone_number": "713-271-2384",
"fax_number": "713-583-2061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "YONNY",
"middle_name": "LUIS",
"credential": "SA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-01",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "14-498",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.