Individual provider Active NPI

Moira R Hizer, PA

  • Physician Assistant
  • Huntsville, AL
National Provider Identifier
1659360790
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.342 Issued in AL
Practice address
201 Governors Dr SW Ste 400
Huntsville, AL 35801-5183
Phone
(256) 265-7246
Fax
(256) 265-7017
NPI assigned
Oct 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.342 AL Primary

Addresses

Primary practice location

201 Governors Dr SW Ste 400
Huntsville, AL 35801-5183

Mailing address

PO Box 11407
Birmingham, AL 35246-0116
Phone (256) 533-7064

Other identifiers 1

IdentifierTypeStateIssuer
891005720MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050428000728 AL Practitioner - Physician Assistant 4284673245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Tennessee Valley Pain CenterGroup PAC ID 4587075783, 33 clinicians

Practice addresses (Care Compare)

201 Governors Dr SW
Suite 400
Huntsville, AL 35801-5183
Phone (256) 265-7246

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Decatur Morgan Hospital - Decatur Campus Hospital, Decatur, AL, CCN 010085

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.342ALMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Pain Management, Inc. Past Accepting new patients
Tennessee Valley Pain Consultants PastSince May 23, 2010 Accepting new patients
Arcand Family Practice LLC Past Accepting new patients

Organizations & group practices 5

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.

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": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1659360790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460116",
            "telephone_number": "256-533-7064",
            "fax_number": "256-704-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 GOVERNORS DR SW STE 400",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358015183",
            "telephone_number": "256-265-7246",
            "fax_number": "256-265-7017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIZER",
        "first_name": "MOIRA",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891005720",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.