Kelsey Nicole Moulton

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

716 Stevens Ave
Portland, ME 04103-2656

Phone

(978) 939-9150

NPI assigned

Mar 10, 2023

Sex

Female

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 MA

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002
• Tufts Medical Center Hospital, Boston, MA, CCN 220116

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
• Direct secure messaging: kmoulton481571@direct.bilh.masshiway.net

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.

• Mount Auburn Professional Services Inc

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1992750996
  Medicare reassignment Care Compare group
• Pratt Medical Group, Inc

  • Internal Medicine Physician
  • Boston, MA
  • NPI 1275570319
  Medicare reassignment Care Compare group
• Mt Auburn Professional Services

  • Internal Medicine Physician
  • Cambridge, MA
  • NPI 1013375203
  NPD

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

• Mount Auburn Hospital

  • General Acute Care Hospital
  • Cambridge, MA
  • NPI 1689670259
  Care Compare affiliation
• Tufts Medical Center, Inc.

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  Care Compare affiliation

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1790486348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-864-8822",
            "fax_number": "617-547-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032656",
            "telephone_number": "978-939-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "KELSEY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Ej Moss, LMSW-CC
• Tovah Z. Moss, M.D.
• Urmi Mota
• Christopher D Motyl, DO
• Joann Elaine Moulton, RDH
• Mercia Eliezer Moumbele Ngolo, INTERPRETER
• Ryan James Mountjoy, M.D.
• Maria A Moustrouphis, LCSW, LADC
• Jessica Moxcey, PHARMD
• Mary Kay Moyer, CRNA

• Physician Assistant in Portland, ME
• Providers in Portland, ME by specialty
• Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.