Madison Alexis Moore, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50.007933RX Issued in OH

Practice address

36701 American Way Ste 3
Avon, OH 44011-4064

Phone

(440) 937-4951

NPI assigned

Mar 13, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Dermatology Partners, Inc.

  • Dermatology Physician
  • Sandusky, OH
  • NPI 1437226636
  NPD
• Dermatologists of Southwestern Ohio, LLC.

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  NPD (past)

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1902432644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24603 E OAKLAND RD",
            "city": "BAY VILLAGE",
            "state": "OH",
            "postal_code": "441402753",
            "telephone_number": "440-915-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36701 AMERICAN WAY STE 3",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114064",
            "telephone_number": "440-937-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MADISON",
        "middle_name": "ALEXIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.007933RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minanti Health LLC
• Latiffa Mitchell
• Tracy Anne Mix, PA-C
• Alexa Mohr
• Jennifer Molenda, RPH
• Tina Moreno, M.A. CCC-SLP
• Anna Morrow, OTD, ATC
• Alexandra Moss, OTR/L
• Amy Muriello
• Melanie Murray, MA, CCC-SLP

• Medical Physician Assistant in Avon, OH
• Providers in Avon, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.