Sang J Moon, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP019643 Issued in PA

Practice address

8118 Old York Rd Ste D
Elkins Park, PA 19027-1423

Phone

(215) 635-3151

Fax

(215) 635-3165

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, HI, NJ3 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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Primary Homecare, LLC

  • Primary Care Nurse Practitioner
  • Elkins Park, PA
  • NPI 1629023593

  Gerontology

  Medicare reassignment NPD
• Signify Health Medical Associates of New Jersey, LLC

  • General Practice Physician
  • Princeton, NJ
  • NPI 1174187728
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  PA

  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  HI

  Medicare reassignment NPD

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1740743855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8118 OLD YORK RD STE D",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271423",
            "telephone_number": "215-635-3151",
            "fax_number": "215-635-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8118 OLD YORK RD STE D",
            "city": "ELKINS PARK",
            "state": "PA",
            "postal_code": "190271423",
            "telephone_number": "215-635-3151",
            "fax_number": "215-635-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "SANG",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP019643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael H. Mittelman, O.D., M.P.H.
• Mary Jane Moessner, PA
• Robert David Mogyoros, DMD
• Emily Claire Molina, DO, MSPH
• Daniel K Moon, M.D., M.S.
• Moor Love Home Care Agency LLC
• Aisha Renee Moore, MSW, LCSW
• Andrew Keely Morgan, ATC LAT
• Mosaic Bloom Counseling LLC
• Multicare House Call Physicians, Inc.

• Gerontology Nurse Practitioner in Elkins Park, PA
• Providers in Elkins Park, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.