Active NPI
Melissa A Moa
- Home Health Agency
- San Antonio, TX
National Provider Identifier
1508349200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 35849
- Practice address
- 4211 Gardendale St Ste A201
San Antonio, TX 78229-3180 - Phone
- (210) 614-4434
- Fax
- (210) 614-4407
- NPI assigned
- Sep 10, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 35849 | TX | Primary |
Addresses
Primary practice location
4211 Gardendale St Ste A201
San Antonio, TX 78229-3180
Mailing address
4910 Lord Rd
San Antonio, TX 78220-3536
Phone (210) 471-1504
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35849 | Other | TX | TX BOARD OF EXAMINERS |
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 |
|---|---|---|---|
| 35849 | TX | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536537600000",
"number": "1508349200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 LORD RD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782203536",
"telephone_number": "210-471-1504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4211 GARDENDALE ST STE A201",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293180",
"telephone_number": "210-614-4434",
"fax_number": "210-614-4407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOA",
"first_name": "MELISSA",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-10",
"last_updated": "2018-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "35849",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX BOARD OF EXAMINERS",
"identifier": "35849",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.