Active NPI
Dylan Michael Moy, PHARMD
- Pharmacist
- Dixon, CA
National Provider Identifier
1619503414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82181
- Practice address
- 1235 Stratford Ave
Dixon, CA 95620-2024 - Phone
- (707) 678-7402
- NPI assigned
- Mar 12, 2020
- Reactivated
- Mar 25, 2020
- Last updated
- Sep 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 82181 | CA | Primary |
Addresses
Primary practice location
1235 Stratford Ave
Dixon, CA 95620-2024
Mailing address
417 Green Hills Dr
Millbrae, CA 94030-1662
Other practice location 1
191 E 3rd Ave
San Mateo, CA 94401-4012
Phone (650) 342-2723
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
- Doctor of Pharmacy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662854400000",
"number": "1619503414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 GREEN HILLS DR",
"city": "MILLBRAE",
"state": "CA",
"postal_code": "940301662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 STRATFORD AVE",
"city": "DIXON",
"state": "CA",
"postal_code": "956202024",
"telephone_number": "707-678-7402"
}
],
"practiceLocations": [
{
"address_1": "191 E 3rd Ave",
"address_purpose": "LOCATION",
"city": "San Mateo",
"state": "CA",
"postal_code": "944014012",
"country_code": "US",
"telephone_number": "650-342-2723",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOY",
"first_name": "DYLAN",
"middle_name": "MICHAEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-12",
"last_updated": "2022-09-11",
"certification_date": "2022-09-11",
"deactivation_date": "2020-03-16",
"reactivation_date": "2020-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dixon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.