Individual provider Active NPI

Alexis Nicole Moloney, FNP-C

  • Family Nurse Practitioner
  • Boerne, TX
National Provider Identifier
1821706151
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1112931 Issued in TX
Practice address
112 Herff Rd Ste 110
Boerne, TX 78006-2751
Phone
(830) 331-8585
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1112931 TX Primary

Addresses

Primary practice location

112 Herff Rd Ste 110
Boerne, TX 78006-2751

Mailing address

111 Bellgrove
Boerne, TX 78015-5165
Phone (210) 364-8528

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230924000001 TX Practitioner - Nurse Practitioner 9638537442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

112 Herff Rd
Suite 110
Boerne, TX 78006-2751
Phone (830) 331-8585

17510 W Grand Pkwy S
Sugar Land, TX 77479-2649

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1112931TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Oct 6, 2023 Accepting new patients
Privia Medical Group Gulf Coast PLLC CurrentSince Oct 6, 2023 Accepting new patients

Locations

112 Herff Rd
Ste 110
Boerne, TX 78006
Phone (830) 331-8181

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: alexis.moloney.1@8042.direct.athenahealth.com

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": "1667779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1821706151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BELLGROVE",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780155165",
            "telephone_number": "210-364-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HERFF RD STE 110",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062751",
            "telephone_number": "830-331-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLONEY",
        "first_name": "ALEXIS",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1112931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.