Individual provider Active NPI

Michael Chay Moua, M.D.

  • Adult Medicine Physician
  • Sacramento, CA
National Provider Identifier
1811299928
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
A128268 Issued in CA
Practice address
7275 E Southgate Dr
Suite 204 - 206
Sacramento, CA 95823-2628
Phone
(916) 428-3788
Fax
(916) 428-0788
NPI assigned
Nov 22, 2010
Last updated
Jan 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA 17667 CA
Adult Medicine Physician 207QA0505X A128268 CA Primary

Addresses

Primary practice location

7275 E Southgate Dr
Suite 204 - 206
Sacramento, CA 95823-2628

Mailing address

7275 E Southgate Dr
Suite 204 - 206
Sacramento, CA 95823-2628
Phone (916) 428-3788

Other names 1

  • Chay Moua Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925001708 CA Practitioner - Family Practice 6507086543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3030 Explorer Dr
Sacramento, CA 95827-2728

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
128268CAMDMarriage & Family Therapist
PA 17667CAMDFamily Medicine Physician
A128268CAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Life Organization, Inc CurrentSince Aug 20, 2014 Accepting new patients
Health and Life Organization, Inc Family Medicine Current Accepting new patients
Health and Life Organization, Inc Past Accepting new patients
Health and Life Organization, Inc. Family Medicine Past Accepting new patients

Locations

3030 Explorer Dr
Sacramento, CA 95827
Phone (916) 254-5700

3314 Fong Ranch Rd
Sacramento, CA 95834

5524 Assembly Ct
Sacramento, CA 95823
Phone (916) 642-1880

7215 55th St
Ste B
Sacramento, CA 95823

7275 E Southgate Dr
Ste 204
Sacramento, CA 95823
Phone (916) 428-3788

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1290384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1811299928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7275 E SOUTHGATE DR",
            "address_2": "SUITE 204 - 206",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232628",
            "telephone_number": "916-428-3788",
            "fax_number": "916-428-0788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7275 E SOUTHGATE DR",
            "address_2": "SUITE 204 - 206",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232628",
            "telephone_number": "916-428-3788",
            "fax_number": "916-428-0788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUA",
        "first_name": "MICHAEL",
        "middle_name": "CHAY",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-22",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "PA 17667",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "A128268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAY",
            "last_name": "MOUA",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.