Jason Anthony Moore, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PAT9110628 Issued in FL

Practice address

13861 Plantation Rd Ste 104
Fort Myers, FL 33912-4342

Phone

(239) 225-1306

Fax

(239) 768-1313

NPI assigned

Sep 14, 2017

Sex

Male

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5830/brand/1/csg/1/fhir/r4

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.

• Fort Myers Internal Medicine LLC

  • Internal Medicine Physician
  • Ft Myers, FL
  • NPI 1346588621
  Medicare reassignment

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902325681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13861 PLANTATION RD STE 104",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124342",
            "telephone_number": "239-225-1306",
            "fax_number": "239-768-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13861 PLANTATION RD STE 104",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124342",
            "telephone_number": "239-225-1306",
            "fax_number": "239-768-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT9110628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Monzone, PA
• Brittany Moody, PTA
• Moonlight Anesthesia, P.L.
• Adam Lawrence Moore, M.ED., CCC-SLP
• Alicia Maria Moore, AU.D.
• Jeffrey Moore, O.D.
• Jessica F Moore, MD
• Latonya Moore
• Lauren Mae Moore, ARNP
• Melinda Lou Moore, LMT

• Medical Physician Assistant in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.