Abigail Rose Moon, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11139 Issued in AZ

Practice address

4530 E Ray Rd Ste 125
Phoenix, AZ 85044-6096

Phone

(602) 343-6167

NPI assigned

Jun 25, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Abigail Kilmer Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: abigail.kilmer.1@14294.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/14294/brand/1/csg/1/fhir/r4

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.

• Arizona OB GYN Affiliates PC

  • Specialist
  • Phoenix, AZ
  • NPI 1750589404

  AZ

  Medicare reassignment
• Arizona OB/GYN Affiliates PC

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1962577650
  NPD (past)

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1801784111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446096",
            "telephone_number": "616-745-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 E RAY RD STE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446096",
            "telephone_number": "602-343-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "ABIGAIL",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "KILMER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kalyani S Moola, M.D.
• Moon Valley Anesthesiologists, LTD
• Moon Valley Dental LLC
• Moon Valley Medical Center PC
• Moon Valley Pediatrics PC
• Alexander Steven Moon, PT
• Anahi Moon, RN
• Eugene Moon, MD
• Karam Moon, MD
• Sangwon Moon

• All providers in Phoenix, AZ
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.