Alyssa Marie Moon

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71014484A Issued in IN

Practice address

138 N Dixon Rd
Kokomo, IN 46901-4154

Phone

(765) 236-8282

NPI assigned

Sep 27, 2023

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial HospitalGroup PAC ID 8123923281, 64 clinicians

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension at Home Home health agency, Pendleton, IN, CCN 157059
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Memorial Hospital Hospital, Logansport, IN, CCN 150072

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Parkview Logansport Hospital, Inc.

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1942317656
  Medicare reassignment Care Compare group NPD
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Family

  Medicare reassignment Care Compare group NPD
• Parkview Logansport Hospital, Inc.

  dba Parkview Logansport Hospital Peru Medical Center

  • Rural Health Clinic/Center
  • Peru, IN
  • NPI 1770248015
  NPD
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Parkview Logansport Hospital Inc

  • General Acute Care Hospital
  • Logansport, IN
  • NPI 1356320469
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  dba Ascension St. Vincent Kokomo

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St.Vincent Home Health-Anderson, LLC

  dba Ascension at Home

  • Home Health Agency
  • Pendleton, IN
  • NPI 1942376843
  Care Compare affiliation

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1497534630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154",
            "telephone_number": "765-236-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Logansport",
            "state": "IN",
            "postal_code": "469471528",
            "country_code": "US",
            "telephone_number": "765-753-0867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "18004578283",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71014484A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alyssa.moon.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "138 N Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "469014154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Momentum Kokomo, LLC
• Megan Mongosa, RBT
• Rikki Monson-Erb
• Kimberley Sue Montgomery, LCSW
• Susan W Moody, LCSW, LCAC, RPT
• Moore Drug Store, Inc. (Moore's Home Health)
• Moore Drug Store, Inc. (Moore's Orthotics and Support)
• Alexia Moore
• Annette M Moore, MD
• Duane W Moore, LMHC

• Family Nurse Practitioner in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.