Individual provider Active NPI

Kristen Leigh Moulton, DO

  • Gastroenterology Physician
  • Worcester, MA
National Provider Identifier
1821559758
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
1023324 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3068
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 1023324 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 885-2225

Other practice location 1

159 Union St
Marlborough, MA 01752-1274
Phone (508) 486-5454

Other practice location 2

28 Newton St
Southborough, MA 01772-1215
Phone (508) 334-3068

Other practice location 3

21 Eastern Ave
Worcester, MA 01605-3094
Phone (508) 334-8419

Other practice location 4

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-3068

Other practice location 5

157 Union St
Marlborough, MA 01752-1228
Phone (508) 334-3068

Other identifiers 1

IdentifierTypeStateIssuer
110153630AMedicaidMA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250516000630 MA Practitioner - Gastroenterology 2860728169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy28
Upper gastrointestinal (GI) endoscopy for acid reflux29

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 1, 2025 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jul 1, 2025 Accepting new patients

Locations

157 Union St
Marlborough, MA 01752
Phone (508) 481-5000

159 Union St
Marlborough, MA 01752
Phone (508) 481-0246

28 Newton St
Southborough, MA 01772
Phone (508) 334-3068

21 Eastern Ave
Worcester, MA 01605
Phone (508) 334-8419

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

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.

Hospital & facility affiliations 4

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1821559758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-885-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3068"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "159 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521274",
            "country_code": "US",
            "telephone_number": "508-486-5454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28 Newton St",
            "address_purpose": "LOCATION",
            "city": "Southborough",
            "state": "MA",
            "postal_code": "017721215",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Eastern Ave",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016053094",
            "country_code": "US",
            "telephone_number": "508-334-8419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "157 Union St",
            "address_purpose": "LOCATION",
            "city": "Marlborough",
            "state": "MA",
            "postal_code": "017521228",
            "country_code": "US",
            "telephone_number": "508-334-3068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "KRISTEN",
        "middle_name": "LEIGH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "1023324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110153630A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.