NPIMap

Individual provider Active NPI

Kayla Marie Moreau

  • Physician Assistant
  • New York, NY
National Provider Identifier
1689459943
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
523 E 72ND St FL 7
New York, NY 10021-4099
Phone
(212) 606-1897
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

523 E 72ND St FL 7
New York, NY 10021-4099

Mailing address

35 S Main St
Pearl River, NY 10965-7577
Phone (800) 275-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125000650 NY Practitioner - Physician Assistant 7416300538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

535 E 70TH St
New York, NY 10021-4823
Phone (646) 797-8471

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
030856NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Society for the Relief of Ruptured & Crippled Maintaining CurrentSince Dec 13, 2023 Accepting new patients
New York Society for the Relief of Ruptured & Crippled Maintaining Past Accepting new patients

Locations

541 E 71st St
New York, NY 10021
Phone (212) 606-1136

541 E 71st St
#4
New York, NY 10021
Phone (212) 774-2837

535 E 70th St
#3
New York, NY 10021
Phone (212) 774-2361

523 E 72nd St
Fl 7
New York, NY 10021
Phone (212) 774-2127

535 E 70th St
New York, NY 10021

Interoperability endpoints

  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/DSTU2
  • FHIR API: https://epicproxy.et0927.epichosted.com/FHIRProxy/api/FHIR/R4/

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.

Hospital & facility affiliations 10

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": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1689459943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 S MAIN ST",
            "city": "PEARL RIVER",
            "state": "NY",
            "postal_code": "109657577",
            "telephone_number": "800-275-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 E 72ND ST FL 7",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100214099",
            "telephone_number": "212-606-1897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREAU",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.