Kristie L Moonan, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

23161 Greater Mack Ave
Saint Clair Shores, MI 48080-1956

Phone

(586) 779-8892

Fax

(586) 779-2869

NPI assigned

Nov 1, 2006

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 MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan Orthopaedic Surgeons PLLCGroup PAC ID 7810277811, 127 clinicians

David Gilboe and Associates IncGroup PAC ID 9638299589, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• David Gilboe and Associates Inc

  • Physical Therapist
  • St Clair Shores, MI
  • NPI 1558458802

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Michigan Orthopaedic Surgeons, PLLC

  • Orthopaedic Surgery Physician
  • Southfield, MI
  • NPI 1306394309
  Medicare reassignment Care Compare group NPD
• David Gilboe & Associates, Inc.

  • Customized Equipment (DME)
  • Saint Clair Shores, MI
  • NPI 1023227857
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1811074255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23161 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801956",
            "telephone_number": "586-779-8892",
            "fax_number": "586-779-2869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23161 GREATER MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801956",
            "telephone_number": "586-779-8892",
            "fax_number": "586-779-2869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26025 Lahser Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480332606",
            "country_code": "US",
            "telephone_number": "248-663-1910",
            "fax_number": "248-849-0190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOONAN",
        "first_name": "KRISTIE",
        "middle_name": "L",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brilio Conrado Mojares, MD
• Gail Ellen Molinari, D.D.S., M.S., M.S.
• Joanna Maria Monaco, LLMSW
• Courtney Lynn Monreal, LMSW
• Joseph Paul Montgomery, PMHNP-BC
• Alexandria Moore
• Jacquan Moore, MS
• Jamisha Moore
• Kara Elizabeth Moore
• Letitia Moore

• Occupational Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.