Courtney Jo Lina Moreau, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

016627-1 Issued in NY

Practice address

400 Westage Business Ctr Dr
Fishkill, NY 12524-2223

Phone

(845) 765-0125

Fax

(845) 765-0128

NPI assigned

Jul 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Courtney Jo Lina Stellwag Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989

Interoperability endpoints

• Direct secure messaging: cmoreau143086@direct.optum.com
• Direct secure messaging: moreauc@hiemail.healtheconnections.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/

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.

• Optum Medical Care, P.C.

  • Cardiovascular Disease Physician
  • Mount Kisco, NY
  • NPI 1982643003
  Medicare reassignment Care Compare group
• Westchester Medical Center Advanced Physician Services, PC

  • Surgery Physician
  • Valhalla, NY
  • NPI 1912131392
  Medicare reassignment
• Optum Medical Care, P.C.

  • Durable Medical Equipment & Medical Supplies
  • New Hyde Park, NY
  • NPI 1053190595
  NPD
• Westchester Medical Center Advanced Physician Services PC

  • Anesthesiology Physician
  • Valhalla, NY
  • NPI 1740687458
  NPD
• Mount Kisco Medical Group

  • Hematology (Internal Medicine) Physician
  • Fishkill, NY
  • NPI 1952356362
  NPD (past)
• Westchester Medical Center

  • General Acute Care Hospital
  • Valhalla, NY
  • NPI 1023286184
  NPD (past)

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

• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1699116129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MAILLER AVE",
            "city": "CORNWALL",
            "state": "NY",
            "postal_code": "125181337",
            "telephone_number": "845-220-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WESTAGE BUSINESS CTR DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242223",
            "telephone_number": "845-765-0125",
            "fax_number": "845-765-0128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREAU",
        "first_name": "COURTNEY",
        "middle_name": "JO LINA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "016627-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "courtney.moreau@wmchealth.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "CERNER",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "19 Bradhurst Ave Ste 3090N",
            "city": "Hawthorne",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105322140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "STELLWAG",
            "middle_name": "JO LINA",
            "prefix": "MS.",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Theresa Montaruli, BA PSYCHOLOGY
• Montefiore Medical Center
• Montefiore Medical Center
• Kimberly Moore, NURSE PRACTITIONER
• Sol Nathan Mora, M.D.
• Alan M Moss, LCSW-R
• Mount Kisco Medical Group
• Melissa Ashley Moustakas, PA-C
• Kevin Mullen, ATC
• Lance D Murphy, MD

• Medical Physician Assistant in Fishkill, NY
• Providers in Fishkill, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.