Individual provider Active NPI

Manny Moy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Milwaukie, OR
National Provider Identifier
1639162795
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000333 Issued in OR
Practice address
6542 SE Lake Rd
Suite 102
Milwaukie, OR 97222-2138
Phone
(506) 659-6686
Fax
(503) 905-6202
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000333 OR Primary

Addresses

Primary practice location

6542 SE Lake Rd
Suite 102
Milwaukie, OR 97222-2138

Mailing address

6542 SE Lake Road
Suite 102
Milwaukie, OR 97222-2245
Phone (506) 659-6686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090929000642 OR Practitioner - Podiatry 4587700885 Reassigns benefits to 1 organization
Practice locations: Milwaukie, OR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6542 SE Lake Rd
Suite 102
Milwaukie, OR 97222-2245
Phone (503) 659-6686

Merit-based Incentive Payment System (MIPS)

Final score
99.11 of 100Reported as apm
Quality
84.29
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue135
Removal of skin lesions1-10
Removal of nail tissue633
Removal or shaving of skin growth477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000333ORMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Extremity Specialists LLC CurrentSince Oct 1, 2013 Accepting new patients
Northwest Extremity Specialists LLC CurrentSince Jun 1, 2015 Accepting new patients

Locations

6542 SE Lake Rd
Ste 102
Portland, OR 97222
Phone (503) 659-6686

9115 SW Oleson Rd
Ste 205
Tigard, OR 97223
Phone (503) 243-5710

Interoperability endpoints

  • Direct secure messaging: manny.moy@pfac.eclinicaldirectplus.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1639162795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6542 SE LAKE ROAD",
            "address_2": "SUITE 102",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222245",
            "telephone_number": "506-659-6686",
            "fax_number": "503-905-6202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6542 SE LAKE RD",
            "address_2": "SUITE 102",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972222138",
            "telephone_number": "506-659-6686",
            "fax_number": "503-905-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOY",
        "first_name": "MANNY",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OR",
            "license": "000333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.