Individual provider Active NPI

Marla L Moon, OD

  • Optometrist
  • State College, PA
National Provider Identifier
1497743785
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG000617 Issued in PA
Practice address
1700 Old Gatesburg Rd Ste 300
State College, PA 16803-2276
Phone
(814) 234-1002
Fax
(814) 234-6251
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG000617 PA Primary

Addresses

Primary practice location

1700 Old Gatesburg Rd Ste 300
State College, PA 16803-2276

Mailing address

1700 Old Gatesburg Rd Ste 300
State College, PA 16803-2276
Phone (814) 234-1002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080918000054 PA Practitioner - Optometry 3375619547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heimer Eye Care Assoc. P.C.Group PAC ID 6204847486, 6 clinicians

Practice addresses (Care Compare)

1700 Old Gatesburg Rd
Suite 300
State College, PA 16803-2276
Phone (814) 234-1002

Merit-based Incentive Payment System (MIPS)

Final score
68.6 of 100Reported as group
Quality
89.01
Improvement activities
40
Cost
10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heimer Eye Care Assoc. P.C. CurrentSince Sep 13, 2021 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

141 Medical Park Ln
#2
Bellefonte, PA 16823
Phone (814) 234-1002

1700 Old Gatesburg Rd
Ste 300
State College, PA 16803
Phone (814) 234-1002

154 Hospital Dr
#3
Tyrone, PA 16686
Phone (814) 234-1002

Interoperability endpoints

  • Direct secure messaging: mmoon@heimereyecare.medentdirect.com
  • Direct secure messaging: drmoon@direct.revolutionehr.com

Organizations & group practices 2

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1497743785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OLD GATESBURG RD STE 300",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032276",
            "telephone_number": "814-234-1002",
            "fax_number": "814-234-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 OLD GATESBURG RD STE 300",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032276",
            "telephone_number": "814-234-1002",
            "fax_number": "814-234-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "MARLA",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG000617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.