Individual provider Active NPI

Laura Moll, PA-C

  • Medical Physician Assistant
  • Merrimack, NH
National Provider Identifier
1518327147
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1269 Issued in NH
Practice address
696 Daniel Webster Hwy
Merrimack, NH 03054-2748
Phone
(603) 429-3155
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA
Medical Physician Assistant 363AM0700X 1269 NH Primary

Addresses

Primary practice location

696 Daniel Webster Hwy
Merrimack, NH 03054-2748

Mailing address

696 Daniel Webster Hwy
Merrimack, NH 03054-2748
Phone (603) 429-3155

Other practice location 1

280 Merrimack St
Suite 103
Lawrence, MA 01843-1779
Phone (978) 685-2455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20170815003867 NH Practitioner - Physician Assistant 4385942200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

10 Jones Rd
Milford, NH 03055-3100
Phone (603) 672-7600

399 Daniel Webster Highwy
Infectious Disease
Merrimack, NH 03054-2748
Phone (603) 429-1611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1269NHMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc. CurrentSince Aug 1, 2017 Accepting new patients
Foundation Medical Partners Inc CurrentSince Aug 1, 2017 Accepting new patients

Locations

696 Daniel Webster Hwy
Merrimack, NH 03054
Phone (603) 429-3155

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1518327147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 DANIEL WEBSTER HWY",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030542748",
            "telephone_number": "603-429-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "696 DANIEL WEBSTER HWY",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030542748",
            "telephone_number": "603-429-3155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Merrimack St",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018431779",
            "country_code": "US",
            "telephone_number": "978-685-2455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLL",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "1269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrimack, NH

Sources for this page

Verify at the official NPI Registry.