Individual provider Active NPI

Leroy Moreno

  • Medical Physician Assistant
  • Edinburg, TX
National Provider Identifier
1861863243
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
H8062 Issued in TX
Practice address
1506 Lonestar Plaza Way Ste 7
Edinburg, TX 78539-0228
Phone
(956) 348-2918
Fax
(956) 348-2927
NPI assigned
Oct 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X H8062 TX Primary

Addresses

Primary practice location

1506 Lonestar Plaza Way Ste 7
Edinburg, TX 78539-0228

Mailing address

2046 S McColl Rd
Edinburg, TX 78539-0228
Phone (956) 393-2200

Other practice location 1

2046 S McColl Rd
Edinburg, TX 78539-0228
Phone (956) 393-2200

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
I20190606001683 TX Practitioner - Physician Assistant 7416280441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Leroy Moreno PA C PLLCGroup PAC ID 0345602827, 4 clinicians

Practice addresses (Care Compare)

1506 S Lone Star Way
Suite 7
Edinburg, TX 78539-4977
Phone (956) 348-2918

Hospital & facility affiliations

  • Doctors Hosptal at Renaissance Hospital, Edinburg, TX, CCN 450869

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H8062TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rio Grande Valley Adult & Internal Medicine Specialists PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leroy.moreno.1@29302.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.

Hospital & facility affiliations 2

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": "1444608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1861863243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 S MCCOLL RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785390228",
            "telephone_number": "956-393-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 LONESTAR PLAZA WAY STE 7",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785390228",
            "telephone_number": "956-348-2918",
            "fax_number": "956-348-2927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2046 S McColl Rd",
            "address_purpose": "LOCATION",
            "city": "Edinburg",
            "state": "TX",
            "postal_code": "785390228",
            "country_code": "US",
            "telephone_number": "956-393-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "LEROY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-12",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "H8062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.