Individual provider Active NPI

Shoua Moua, NP

  • Nurse Practitioner
  • Beaumont, CA
National Provider Identifier
1750070900
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95023963 Issued in CA
Practice address
839 Highland Springs Ave
Beaumont, CA 92223-5767
Phone
(909) 793-3311
NPI assigned
May 3, 2023
Last updated
Jan 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95023963 CA Primary

Addresses

Primary practice location

839 Highland Springs Ave
Beaumont, CA 92223-5767

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Other practice location 1

1100 N Palm Canyon Dr Ste 206
Palm Springs, CA 92262-4426
Phone (760) 883-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20230524000852 CA Practitioner - Nurse Practitioner 5294191854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Heart Rhythm Consultants IncGroup PAC ID 9830227362, 3 clinicians
Beaver Medical Group P CGroup PAC ID 0547164295, 251 clinicians

Practice addresses (Care Compare)

1100 N Palm Canyon Dr
Suite 206
Palm Springs, CA 92262-4426
Phone (760) 883-1600

5957 W Ramsey St
Banning, CA 92220-3058
Phone (951) 845-0313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95023963CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cassidy Medical Group Inc. Single Specialty Current Accepting new patients
Beaver Medical Group P C Single Specialty CurrentSince May 1, 2025 Accepting new patients
Centers for Family Medicine GP Single Specialty Current Accepting new patients
Beaver Medical Group P C Single Specialty CurrentSince May 1, 2025 Accepting new patients
Desert Heart Rhythm Consultants Inc Single Specialty CurrentSince May 22, 2023 Accepting new patients
Diagnostic Imaging Services Single Specialty PastSince May 1, 2023 Accepting new patients

Locations

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

1100 N Palm Canyon Dr
Ste 206
Palm Springs, CA 92262
Phone (760) 778-5220

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

2 W Fern Ave
#1112
Redlands, CA 92373

145 Thunder Dr
Vista, CA 92083
Phone (760) 630-5487

145 Thunder Dr
#1182
Vista, CA 92083
Phone (760) 941-9002

Interoperability endpoints

  • Direct secure messaging: smoua26175@epiclp.direct-ci.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1750070900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 HIGHLAND SPRINGS AVE",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922235767",
            "telephone_number": "909-793-3311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 N Palm Canyon Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Palm Springs",
            "state": "CA",
            "postal_code": "922624426",
            "country_code": "US",
            "telephone_number": "760-883-1600",
            "fax_number": "760-520-6644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUA",
        "first_name": "SHOUA",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95023963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, CA

Sources for this page

Verify at the official NPI Registry.