Active NPI
Kao Feng Moua, MD
- Family Medicine Physician
- Plymouth, WI
National Provider Identifier
1528319472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 7088-851
- Practice address
- 2600 Kiley Way
Plymouth, WI 53073-5020 - Phone
- (920) 449-7000
- NPI assigned
- Oct 1, 2012
- Last updated
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 240959 | WI | |
| Family Medicine Physician | 207Q00000X | 7088-851 | WI | Primary |
Addresses
Primary practice location
2600 Kiley Way
Plymouth, WI 53073-5020
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
425 Wind Ridge Dr
Wausau, WI 54401-4149
Phone (715) 675-3391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100088461 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Minnesota Medical School, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2600 Kiley Way
Plymouth, WI 53073-5020
Phone (920) 449-7000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7088-851 | WI | MD | Family Medicine Physician |
| 240959 | WI | MD | Medical Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2600 Kiley Way
Plymouth, WI 53073
Phone (920) 449-7000
Interoperability endpoints
- kmoua384704@direct.myadvocateaurora.org
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Family Medicine
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sheboygan, WI
- NPI 1902023955
Hospital
-
dba Aurora Medical Center Sheboygan County
- General Acute Care Hospital
- Sheboygan, WI
- NPI 1922053107
-
dba Aurora at Home
- Home Health Agency
- Green Bay, WI
- NPI 1932361763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1528319472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 KILEY WAY",
"city": "PLYMOUTH",
"state": "WI",
"postal_code": "530735020",
"telephone_number": "920-449-7000"
}
],
"practiceLocations": [
{
"address_1": "425 Wind Ridge Dr",
"address_purpose": "LOCATION",
"city": "Wausau",
"state": "WI",
"postal_code": "544014149",
"country_code": "US",
"telephone_number": "715-675-3391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOUA",
"first_name": "KAO FENG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-01",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "WI",
"license": "240959",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WI",
"license": "7088-851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100088461",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.