Individual provider Active NPI

Willy Moy, PA-C

  • Surgical Physician Assistant
  • North Easton, MA
National Provider Identifier
1558615906
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA4493 Issued in MA
Practice address
15 Roche Bros Way
North Easton, MA 02356-1000
Phone
(781) 344-3535
Fax
(508) 535-0192
NPI assigned
Nov 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA4493 MA Primary

Addresses

Primary practice location

15 Roche Bros Way
North Easton, MA 02356-1000

Mailing address

PO Box 30
Stoughton, MA 02072-0030
Phone (781) 344-3535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20130104000444 MA Practitioner - Physician Assistant 1153574827 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Physician Services LLCGroup PAC ID 1456348127, 15 clinicians

Practice addresses (Care Compare)

90 Everett Ave
Chelsea, MA 02150-2311
Phone (413) 301-6019

95 Frank B Murray St
Springfield, MA 01103-1106
Phone (413) 301-6019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA4493MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Care Physician Network, LLC CurrentSince Nov 1, 2013 Accepting new patients
Orthopedic Care Physician Network LLC CurrentSince Nov 1, 2013 Accepting new patients
University Orthopedics, Inc. Past Accepting new patients

Locations

10 Reservoir St
Ste 101
Mansfield, MA 02048
Phone (508) 618-7111

15 Roche Brothers Way
Ste 200
North Easton, MA 02356
Phone (401) 490-1939

15 Roche Brothers Way
North Easton, MA 02356
Phone (781) 545-9273

Interoperability endpoints

  • Direct secure messaging: willy.moy.1@13709.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1558615906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020720030",
            "telephone_number": "781-344-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ROCHE BROS WAY",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023561000",
            "telephone_number": "781-344-3535",
            "fax_number": "508-535-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "WILLY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-07",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA4493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

Verify at the official NPI Registry.