Katherine Elizabeth Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110008920 Issued in VA

Practice address

8316 Arlington Blvd Ste 401
Fairfax, VA 22031-5216

Phone

(703) 641-9666

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derm Associates LLCGroup PAC ID 4688653306, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Derm Associates LLC

  • Dermatology Physician
  • Silver Spring, MD
  • NPI 1649271354

  DC

  Medicare reassignment Care Compare group NPD
• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Emergency Medicine Associates P.a., P.C.

  • Emergency Medicine Physician
  • Falls Church, VA
  • NPI 1134117393

  DC

  Medicare reassignment
• Emergency Medicine Associates P.a., P.C.

  • Internal Medicine Physician
  • Culpeper, VA
  • NPI 1881559102
  NPD
• Emergency Medicine Associates, PA

  • Emergency Medicine Physician
  • Bowie, MD
  • NPI 1225889272
  NPD
• Hema a. Sundaram, M.D.,P.a

  • Specialist
  • Rockville, MD
  • NPI 1366626814
  NPD (past)

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1730818089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD STE 401",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315216",
            "telephone_number": "703-641-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 ARLINGTON BLVD STE 401",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220315216",
            "telephone_number": "703-641-9666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11119 Rockville Pike Ste 205",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208523143",
            "country_code": "US",
            "telephone_number": "301-984-3376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHERINE",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110008920",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C09123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Joy Moore, PA
• Destini Moore
• Grace Moore, LCSW
• Janae Moore
• Jessica Moore
• Kenisha Nicole Moore
• Margaret Moore, MA
• Michael Moore, MD
• Peyton Moore
• Stuart Coleman Moore, LCSW

• Physician Assistant in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.