Bonnie Lynn Moon, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95031601 Issued in CA

Practice address

5901 Green Valley Cir Ste 405
Culver City, CA 90230-6971

Phone

(424) 266-7474

NPI assigned

Aug 29, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.73523

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.

• The Achievable Foundation

  • Federally Qualified Health Center (FQHC)
  • Culver City, CA
  • NPI 1164771747
  Medicare reassignment NPD
• Afshin Akhavan D.O., a Professional Corporation

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1821210329
  NPD
• The Achievable Foundation

  • Federally Qualified Health Center (FQHC)
  • Culver City, CA
  • NPI 1891593778
  NPD (past)

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1508690603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE POINTE STE 270",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902308735",
            "telephone_number": "424-266-7474",
            "fax_number": "310-596-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 GREEN VALLEY CIR STE 405",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306971",
            "telephone_number": "424-266-7474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Corporate Pointe Ste 50",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902308726",
            "country_code": "US",
            "telephone_number": "424-266-7474",
            "fax_number": "310-596-8268",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95031601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Leslie Montgomery, D.P.M.
• Ruth Montiel
• Carolina R Montilla Acuna
• Daniel Anthony Montoya
• Vivian Montoya, DACCHM, L.AC
• Emily Mooradian, RBT
• Craig Moore, RDN
• Damon Lamont Moore
• Jennifer J Moore
• Keniah Moore

• Family Nurse Practitioner in Culver City, CA
• Providers in Culver City, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.