Jordan Edward Moon, PA-C, MPH

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA179905 Issued in OR

Practice address

2280 Marcola Rd
Springfield, OR 97477-2594

Phone

(541) 747-4300

Fax

(541) 747-0655

NPI assigned

Sep 13, 2016

Last updated

Jun 9, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Medical Homes, LLCGroup PAC ID 0042100372, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Signature Healthcare at Home Home health agency, Eugene, OR, CCN 387140

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northwest Medical Homes, LLC

  dba Springfield Family Physicians

  • Family Medicine Physician
  • Springfield, OR
  • NPI 1114974946
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Willamette Healthcare LLC

  dba Signature Healthcare at Home

  • Home Health Agency
  • Eugene, OR
  • NPI 1013733211
  Care Compare affiliation

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1770031221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 MARCOLA RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772594",
            "telephone_number": "541-747-4300",
            "fax_number": "541-747-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "JORDAN",
        "middle_name": "EDWARD",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-13",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA179905",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA179905",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500715905",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trisha J Mitchell, M.D.
• Jubeen Moaven, MD
• Kevin Andrew Modeste, M.D.
• Darcy Marie Mofield, NCMA
• Calvin Johnny Montgomery
• Christella Moore, LPN
• Emily Moore, BA HUMAN PHYSIOLOGY
• Erin Brianne Moore, MS
• Frances K Moore, LPN
• Gregory Anthony Moore, M.D.

• Physician Assistant in Springfield, OR
• Providers in Springfield, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.