Maurie Moline

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

825 E 1700 S
Salt Lake City, UT 84105-3225

Phone

(972) 655-8714

NPI assigned

Oct 8, 2018

Last updated

Oct 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

University of Utah School of Medicine, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Big Leap Medical Group PA

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1821841503
  Medicare reassignment NPD

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

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1598230302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E 1700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053225",
            "telephone_number": "972-655-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E 1700 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053225",
            "telephone_number": "972-655-8714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINE",
        "first_name": "MAURIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Moleni
• Daniela Paz Molina Villanueva, CSW
• Isabel Teresa Molina-Avella, PH.D. SOCIAL WORK
• Christian Molina
• Keidy M Molina, FRF
• Samantha Moll
• Amber Dawn Moller
• Heidi Molloy
• Heather Molyneaux
• Tenneh Momoh

• Physician Assistant in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.

Verify at the official NPI Registry.