Individual provider Active NPI

Rachael Moon, ATC

  • Physical Therapist
  • Canonsburg, PA
National Provider Identifier
1801339171
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
641 Woodland Rd
Canonsburg, PA 15317-3858
Phone
(714) 357-5243
NPI assigned
Nov 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X RT006143 PA
Physical Therapist 225100000X Primary

Addresses

Primary practice location

641 Woodland Rd
Canonsburg, PA 15317-3858

Mailing address

641 Woodland Rd
Canonsburg, PA 15317-3858
Phone (714) 357-5243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912002301 PA Practitioner - Physical Therapist in Private Practice 6406396720 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drayer Physical Therapy Institute LLCGroup PAC ID 8224948666, 213 clinicians

Practice addresses (Care Compare)

2 B Old Clairton Rd
Pittsburgh, PA 15236-3905
Phone (412) 328-2550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RT006143PAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Jul 15, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2B Old Clairton Rd
Pittsburgh, PA 15236
Phone (412) 328-2550

Organizations & group practices 2

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": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1801339171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 WOODLAND RD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153173858",
            "telephone_number": "714-357-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 WOODLAND RD",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153173858",
            "telephone_number": "714-357-5243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "RACHAEL",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "PA",
            "license": "RT006143",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.