Individual provider Active NPI

Leda Moe, APRN

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1790347979
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
000000 Issued in FL
Practice address
3625 University Blvd. S.
Jacksonville, FL 32216-4207
Phone
(904) 702-6089
NPI assigned
Jul 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 000000 FL Primary

Addresses

Primary practice location

3625 University Blvd. S.
Jacksonville, FL 32216-4207

Mailing address

2040 Paradise Oaks CT.
Jacksonville, FL 32233
Phone (904) 415-2705

Other names 1

  • Leda Hansen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190919002033 FL Practitioner - Nurse Practitioner 6406186352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paragon Emergency Services LLCGroup PAC ID 8628153087, 401 clinicians

Practice addresses (Care Compare)

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 702-6111

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000000FLMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Aug 30, 2023 Accepting new patients
Cep America, LLC Current Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Dec 1, 2022 Accepting new patients
Florida Institute of Pain Medicine LLC CurrentSince Dec 1, 2022 Accepting new patients
Paragon Emergency Services LLC CurrentSince Aug 28, 2019 Accepting new patients
Cep America LLC CurrentSince Aug 30, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

9820 Hutchinson Park Dr
Jacksonville, FL 32225
Phone (904) 450-6740

4796 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 449-7246

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

8083 Parramore Rd
Jacksonville, FL 32244
Phone (904) 450-6760

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

105 Whitehall Dr
Ste 115
St Augustine, FL 32086
Phone (904) 800-7246

1451 El Camino Real
The Villages, FL 32159
Phone (352) 751-8000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1790347979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 PARADISE OAKS CT.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32233",
            "telephone_number": "904-415-2705",
            "fax_number": "865-291-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD. S.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-702-6089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "LEDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEDA",
            "last_name": "HANSEN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.