Keng Moua, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

615 Lilly Rd NE Ste 100
Olympia, WA 98506-5117

Phone

(360) 491-4211

Fax

(360) 493-0407

NPI assigned

Jul 3, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

University of Wisconsin School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Merit-based Incentive Payment System (MIPS)

Final score

79.72 of 100Reported as group

Quality

71.87

Promoting interoperability

76

Improvement activities

40

Cost

80.52

Merit-based Incentive Payment System (MIPS)

Final score

88.86 of 100Reported as group

Quality

75.41

Promoting interoperability

100

Improvement activities

40

Cost

87.45

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: keng.moua.1@5512.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group
• Olympia Orthopaedic Associates PLLC

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
  • NPI 1083785398
  Medicare reassignment NPD
• Southern Oregon Orthopedics Inc

  • Orthopaedic Surgery Physician
  • Medford, OR
  • NPI 1518093376

  Physician Assistant

  Medicare reassignment NPD
• Olympia Orthopaedic Associates, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Centralia, WA
  • NPI 1134089576
  NPD

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

• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1656806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1639802135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070368",
            "telephone_number": "360-491-8439",
            "fax_number": "360-491-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 LILLY RD NE STE 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065117",
            "telephone_number": "360-491-4211",
            "fax_number": "360-493-0407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065196",
            "country_code": "US",
            "telephone_number": "360-923-7000",
            "fax_number": "360-923-7089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUA",
        "first_name": "KENG",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-03",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2289590",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Kevin Moss, D.D.S.
• Kurt W Moss, P.T.
• Lane Moss
• Ruth Kim Ann Moss, BA, PBP, LMP
• Kelsey Lou Mothershead
• Melvin Leroy Mould II, CERTIFIED INTERPRETE
• Diane Elizabeth Moulton
• Rachael I Moulton, LMT
• Rupinder Moundhi, MD
• Mount Rainier Urology, Inc, PS

• Physician Assistant in Olympia, WA
• Providers in Olympia, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.