Individual provider Active NPI

Jing Fon Moy, D.O.

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1629206768
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A11803 Issued in CA
Practice address
1450 E Holt Ave
Pomona, CA 91767-5822
Phone
(909) 630-7927
Fax
(909) 620-6719
NPI assigned
Jun 27, 2009
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A11803 CA Primary

Addresses

Primary practice location

1450 E Holt Ave
Pomona, CA 91767-5822

Mailing address

PO Box 742244
Los Angeles, CA 90074-2244
Phone (408) 340-5700

Other practice location 1

15425 Los Gatos Blvd
Ste 120
Los Gatos, CA 95032-2541
Phone (408) 340-5700

Other identifiers 2

IdentifierTypeStateIssuer
1417211426MedicaidCA
HA329ZOtherMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130321000283 CA Practitioner - Family Practice 8123263183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pomona Community Health CenterGroup PAC ID 5890940605, 7 clinicians

Practice addresses (Care Compare)

1556 S Sultana Ave
Ontario, CA 91761-4238
Phone (909) 984-7384

2680 E Riverside Dr
Ontario, CA 91761-7307
Phone (909) 630-7927

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pomona Community Health Center CurrentSince Nov 17, 2023 Accepting new patients
Pomona Community Health Center Current Accepting new patients

Locations

1556 S Sultana Ave
Ontario, CA 91761
Phone (909) 418-6923

1450 E Holt Ave
Pomona, CA 91767

Interoperability endpoints

  • Direct secure messaging: jingfon.moy.p3@direct.parktreechc.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1629206768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742244",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742244",
            "telephone_number": "408-340-5700",
            "fax_number": "510-974-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675822",
            "telephone_number": "909-630-7927",
            "fax_number": "909-620-6719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15425 LOS GATOS BLVD",
            "address_2": "STE 120",
            "address_purpose": "LOCATION",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322541",
            "country_code": "US",
            "telephone_number": "408-340-5700",
            "fax_number": "510-974-8322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOY",
        "first_name": "JING",
        "middle_name": "FON",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-27",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417211426",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "HA329Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.