Individual provider Active NPI

John A Moon, LCSW

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1508088808
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21213 Issued in TX
Practice address
8535 Tom Slick
San Antonio, TX 78229-3367
Phone
(210) 616-0300
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21213 TX Primary

Addresses

Primary practice location

8535 Tom Slick
San Antonio, TX 78229-3367

Mailing address

8535 Tom Slick
San Antonio, TX 78229-3367
Phone (210) 616-0300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240628001379 TX Practitioner - Clinical Social Worker 3476097676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5788 Eckhert Rd
San Antonio, TX 78240-3900
Phone (210) 450-7222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21213TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince May 20, 2024 Accepting new patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince May 20, 2024 Accepting new patients

Locations

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8535 Tom Slick
San Antonio, TX 78229
Phone (210) 582-6440

5788 Eckhert Rd
San Antonio, TX 78240
Phone (210) 450-6450

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1508088808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-616-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 TOM SLICK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293367",
            "telephone_number": "210-616-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "21213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.