Individual provider Active NPI

Kathryn Christine Moles, PA-C

  • Medical Physician Assistant
  • Paoli, PA
National Provider Identifier
1881684165
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA053459 Issued in PA
Practice address
2 Industrial Blvd Ste 200
Paoli, PA 19301-1648
Phone
(610) 647-2400
NPI assigned
Oct 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002162 VA
Medical Physician Assistant 363AM0700X MA053459 PA Primary

Addresses

Primary practice location

2 Industrial Blvd Ste 200
Paoli, PA 19301-1648

Mailing address

207 N Broad St FL 3
Philadelphia, PA 19107-1500
Phone (610) 647-2400

Other practice location 1

4320 Seminary Rd
Alexandria, VA 22304-1535
Phone (703) 504-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240622000108 MD Practitioner - Physician Assistant 0042236663 Reassigns benefits to 1 organization
I20240710004680 DC Practitioner - Physician Assistant 0042236663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1307 Merritt Blvd
Dundalk, MD 21222-2109
Phone (410) 288-2121

1354 Eastern Blvd
Expresscare of Essex
Essex, MD 21221-3423
Phone (443) 231-5203

1470 Martin Blvd
Middle River, MD 21220-4105
Phone (443) 231-5203

1505 E Churchville Rd
Bel Air, MD 21014-4742

2006 Rock Spring Rd
Forest Hill, MD 21050-2607
Phone (410) 569-0044

5 Bel Air S Pkwy
Suite 1535
Bel Air, MD 21015-3816
Phone (410) 569-0044

7700 Belair Rd
Baltimore, MD 21236-4004
Phone (410) 665-0670

7701 Harford Rd
Parkville, MD 21234-6403
Phone (410) 569-0069

8000 Loch Raven Blvd
Loch Raven, MD 21286-8337
Phone (410) 616-9027

Merit-based Incentive Payment System (MIPS)

Final score
89.23 of 100Reported as group
Quality
86.8
Promoting interoperability
100
Improvement activities
40
Cost
77.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110002162VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC CurrentSince May 4, 2024 Accepting new patients
MNR Industries, LLC CurrentSince May 1, 2024 Accepting new patients
MNR Industries LLC CurrentSince May 1, 2024 Accepting new patients
MNR Industries LLC Current Accepting new patients

Locations

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 6

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": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1881684165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "610-647-2400",
            "fax_number": "610-647-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INDUSTRIAL BLVD STE 200",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011648",
            "telephone_number": "610-647-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 Seminary Rd",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223041535",
            "country_code": "US",
            "telephone_number": "703-504-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLES",
        "first_name": "KATHRYN",
        "middle_name": "CHRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002162",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA053459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.