Richard Dominick Moro, PAC
Individual provider Active NPI Physician Assistant · Plainfield, CT
NPI 1700859006 · NPPES record last updated May 27, 2022
Key facts
- NPI
- 1700859006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 001890 (CT)
- Practice address
- 558 Norwich Rd
Plainfield, CT 06374-1725 - Phone
- (608) 564-4054
- Fax
- (608) 564-0354
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Healthcall Primary Care Center PC
Healthcall Medical Center,LLC
Practice addresses (Care Compare)
2 Lathrop Ave
Norwich, CT 06360-2340
Phone (860) 204-0883
558 Norwich Rd
Plainfield, CT 06374-1725
Phone (860) 564-4054
Hospital & facility affiliations
- Hartford Healthcare at Home
- William W Backus Hospital
- Day Kimball Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 85.38
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070808000265 | CT | Practitioner - Physician Assistant | 7719904903 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004547 | NY | MD | Clinical Psychologist |
| 001890 | CT | MD | Gastroenterology Registered Nurse |
| 104122 | NC | MD | Psychiatric/Mental Health Registered Nurse |
| 004547-1 | NY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Helar Campos MD & Associates Family Medical Center, LLC | Current |
Accepting new patients | |
| Community Health Center Inc | Current |
Accepting new patients |
Locations
435 Montauk Ave
New London, CT 06320
Phone (860) 443-1136
196 Parkway S
Ste 304
Waterford, CT 06385
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 104122 | NC | |
| Physician Assistant | 363A00000X | 004547-1 | NY | |
| Medical Physician Assistant | 363AM0700X | 001890 | CT | |
| Physician Assistant | 363A00000X | 001890 | CT | Yes |
Addresses
Primary practice location
558 Norwich Rd
Plainfield, CT 06374-1725
Mailing address
558 Norwich Rd
Plainfield, CT 06374-1725
Phone (608) 564-4054
Other practice location 1
435 Montauk Ave
New London, CT 06320-4621
Phone (860) 444-7400
Other providers in Plainfield, CT
- Catherine Joan Mestemaker-Harris
- Mohan LLC
- Manik Mohan
- Lisa Mooney
- Allison Brenna Morin
- Christopher Morse
- Nolan Patrick Murphy
- Samer Nasser-Eddin
- Leilani L Nixon
- Northeastpsychotherapy Associates, LLC
All providers in Plainfield, CT · Physician Assistant in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.