Active NPI
Freddy Moreno, PA-C
- Surgical Physician Assistant
- Melbourne, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA113159
- Practice address
- 1350 Hickory St
Melbourne, FL 32901-3224 - Phone
- (321) 434-1401
- NPI assigned
- Mar 6, 2020
- Last updated
- Jul 12, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | NU | ||
| Surgical Physician Assistant | 363AS0400X | PA113159 | FL | Primary |
Addresses
Primary practice location
1350 Hickory St
Melbourne, FL 32901-3224
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106071500 | Medicaid | FL | |
| O8400 | Other | FL | HF MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401
699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562
7125 Murrell Rd
Viera, FL 32940-7999
Phone (321) 242-8790
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA113159 | FL | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health First Medical Group, LLC | Current | Accepting new patients |
Locations
699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272
730 Malabar Rd
Ste C
Malabar, FL 32950
Phone (321) 434-3350
1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771
1350 Hickory St
Ste 101
Melbourne, FL 32901
Phone (321) 434-1401
3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771
Networks
- Freedom Health HMO Network
Interoperability endpoints
- fmoreno23878@epicdirect.hf.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Melbourne, FL
- NPI 1750626495
-
- Orthopaedic Trauma Physician
- Melbourne, FL
- NPI 1336390020
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Palm Bay Hospital
- General Acute Care Hospital
- Palm Bay, FL
- NPI 1386940823
-
dba First Flight
- Air Ambulance
- Melbourne, FL
- NPI 1235312281
Hospital
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1295702728
-
- General Acute Care Hospital
- Melbourne, FL
- NPI 1730494816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720742400000",
"number": "1851926158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 HICKORY ST",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013224",
"telephone_number": "321-434-1401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "FREDDY",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-06",
"last_updated": "2024-07-12",
"certification_date": "2024-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": "PA113159",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "106071500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HF MA",
"identifier": "O8400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.
- 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.