Active NPI
James Moon, M.D.
- Hospitalist Physician
- Loma Linda, CA
National Provider Identifier
1639601685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- A166098
- Practice address
- 11201 Benton St
Loma Linda, CA 92357-5916 - Phone
- (909) 825-7084
- NPI assigned
- Mar 29, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A166098 | CA | |
| Hospitalist Physician | 208M00000X | A166098 | CA | Primary |
Addresses
Primary practice location
11201 Benton St
Loma Linda, CA 92357-5916
Mailing address
15970 Los Serranos Country Club Dr PMB 140
Chino Hills, CA 91709-4523
Phone (858) 218-6222
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A166098 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaver Medical Group P C | Multi-Specialty | Current | Accepting new patients |
| Beaver Medical Group P C | Multi-Specialty | Current | Accepting new patients |
| Beaver Medical Group P C | Multi-Specialty | Past | Accepting new patients |
Locations
2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137
2 W Fern Ave
#1112
Redlands, CA 92373
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Organizations & group practices 3
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": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1639601685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15970 LOS SERRANOS COUNTRY CLUB DR PMB 140",
"city": "CHINO HILLS",
"state": "CA",
"postal_code": "917094523",
"telephone_number": "858-218-6222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 BENTON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923575916",
"telephone_number": "909-825-7084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JAMES",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-29",
"last_updated": "2025-05-12",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "A166098",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "CA",
"license": "A166098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.