Individual provider Active NPI

Kathryne Moyer, PA

  • Physician Assistant
  • Leonardtown, MD
National Provider Identifier
1679094122
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone
(855) 633-0231
NPI assigned
Jul 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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 Primary

Addresses

Primary practice location

25500 Point Lookout Rd
Leonardtown, MD 20650-2015

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200925001870 NC Practitioner - Physician Assistant 1850657735 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

1900 Kildaire Farm Rd
Cary, NC 27518-6616
Phone (919) 233-2300

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-8000

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
75.66
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3495SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA CurrentSince Jan 1, 2021 Accepting new patients
Wake Emergency Physicians PA CurrentSince Jan 1, 2021 Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: kmoyer106637@capefearvalley.direct-ci.com

Organizations & group practices 4

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": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1679094122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502015",
            "telephone_number": "855-633-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "KATHRYNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

Verify at the official NPI Registry.