Individual provider Active NPI

Amy M Moss, PAC

  • Physician Assistant
  • Wyomissing, PA
National Provider Identifier
1861479487
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0003000 Issued in MD
Practice address
1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone
(610) 374-4401
Fax
(610) 374-7916
NPI assigned
Dec 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0003000 MD Primary

Addresses

Primary practice location

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002

Mailing address

1011 Reed Ave
Suite 300
Wyomissing, PA 19610-2002
Phone (610) 374-4401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20170601002286 PA Practitioner - Physician Assistant 9234185034 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Jul 1, 2019 Accepting new patients
Midatlantic Endoscopy LLC Current Accepting new patients
Westwyo Services LP PastSince May 1, 2015 Accepting new patients

Locations

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

1011 Reed Ave
Ste 300
Wyomissing, PA 19610
Phone (610) 374-4401

Interoperability endpoints

  • Direct secure messaging: amymoss@ddal.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1861479487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 REED AVE",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102002",
            "telephone_number": "610-374-4401",
            "fax_number": "610-374-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 REED AVE",
            "address_2": "SUITE 300",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196102002",
            "telephone_number": "610-374-4401",
            "fax_number": "610-374-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.