Individual provider Active NPI

Kathryn Moore, PA-C

  • Medical Physician Assistant
  • Cambridge, MA
National Provider Identifier
1699307538
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA8030 Issued in MA
Practice address
300 Mount Auburn St Ste 414
Cambridge, MA 02138-5665
Phone
(617) 864-0503
Fax
(617) 441-4033
NPI assigned
Feb 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA8030 MA Primary
Physician Assistant 363A00000X PA8030 MA

Addresses

Primary practice location

300 Mount Auburn St Ste 414
Cambridge, MA 02138-5665

Mailing address

300 Mount Auburn St Ste 414
Cambridge, MA 02138-5665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MA2 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

Enrollment IDStateProvider typePAC IDDetails
I20210920001117 VA Practitioner - Physician Assistant 6507263472 Reassigns benefits to 1 organization
I20230125001709 MA Practitioner - Physician Assistant 6507263472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Practice addresses (Care Compare)

300 Mount Auburn St
Cambridge, MA 02138-5600
Phone (617) 499-5055

330 Mount Auburn St
Cambridge, MA 02138-5502

57 Bedford St
Suite 130
Lexington, MA 02420-4543
Phone (781) 862-7500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Auburn Professional Services CurrentSince Nov 6, 2023 Accepting new patients

Locations

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

300 Mount Auburn St
Ste 414
Cambridge, MA 02138
Phone (617) 864-0503

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • Direct secure messaging: kmoore92002@tuftsmedicine.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kmoore560312@direct.bilh.masshiway.net

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.

Hospital & facility affiliations 1

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": "1581206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1699307538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST STE 414",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST STE 414",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385665",
            "telephone_number": "617-864-0503",
            "fax_number": "617-441-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-09",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA8030",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.