Mary Jennalyn Q Moreno

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95099039 Issued in CA

Practice address

2070 Clinton Ave
Alameda, CA 94501-4399

Phone

(510) 814-4397

Fax

(510) 814-4391

NPI assigned

Jun 24, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Advanced Care IncGroup PAC ID 4981066834, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Piedmont Advanced Care Inc

  • Internal Medicine Physician
  • Oakland, CA
  • NPI 1871286427
  Medicare reassignment Care Compare group NPD
• E P Magalong Jr MD Inc

  • Internal Medicine Physician
  • Alameda, CA
  • NPI 1124787171
  Medicare reassignment NPD

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1881255560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 KARA RD",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945027701",
            "telephone_number": "510-759-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 CLINTON AVE",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014399",
            "telephone_number": "510-814-4397",
            "fax_number": "510-814-4391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MARY JENNALYN",
        "middle_name": "Q",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95099039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaun Fionna Morados
• Terra Morais, PSYD
• Tsitlaly Gorgette Morales Vazquez
• Natalie Marie Morales
• Leticia Moreno
• Monica Moreno, CMT
• Paola Moreno
• Yvette Moreno
• Isaac Morfin
• Darrance Galontae Morgan

• Family Nurse Practitioner in Alameda, CA
• Providers in Alameda, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.

Verify at the official NPI Registry.