Individual provider Active NPI

Joshua Moen, PA

  • Physician Assistant
  • Greenwood Village, CO
National Provider Identifier
1578128740
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5445 DTC Pkwy Ste P4
Greenwood Village, CO 80111-3059
Phone
(720) 528-4000
NPI assigned
May 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5445 DTC Pkwy Ste P4
Greenwood Village, CO 80111-3059

Mailing address

5445 DTC Pkwy Ste P4
Greenwood Village, CO 80111-3059

Other practice location 1

14232 Southern Pines Dr
Farmers Branch, TX 75234-3720
Phone (580) 302-3424

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
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1578128740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE P4",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 DTC PKWY STE P4",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801113059",
            "telephone_number": "720-528-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14232 Southern Pines Dr",
            "address_purpose": "LOCATION",
            "city": "Farmers Branch",
            "state": "TX",
            "postal_code": "752343720",
            "country_code": "US",
            "telephone_number": "580-302-3424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOEN",
        "first_name": "JOSHUA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-03",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood Village, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.