Gianna Moulton, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA058829 Issued in PA

Practice address

560 Pierce St
Kingston, PA 18704-5716

Phone

(570) 283-2161

Fax

(570) 714-0670

NPI assigned

Jan 13, 2017

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

Other names 1

• Gianna Cordasco Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• My Catholic Doctor, P.L.L.C.

  • Pediatrics Physician
  • New Canaan, CT
  • NPI 1396201307
  NPD (past)

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

{
    "created_epoch": "1484265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1609312677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 PIERCE ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045716",
            "telephone_number": "570-283-2161",
            "fax_number": "570-714-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "GIANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-13",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA058829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GIANNA",
            "last_name": "CORDASCO",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Princess Morgan
• Santina Morreale, DC
• Brian J Morris, DPM
• Marguerite A Mosack, PHD
• Joseph Motzko, AU.D.
• Anthony Mozeleski, ATC
• Suzanne Mulvey, CRNA
• Devon Anna Munley, CRNP
• April Murphy, RDN, LDN
• Samantha Diane Mushak, PA-C

• Physician Assistant in Kingston, PA
• Providers in Kingston, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.