Michael Moreno, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA62509 Issued in CA

Practice address

1206 E 17TH St Ste 101
Santa Ana, CA 92701-2641

Phone

(714) 352-2911

NPI assigned

Nov 4, 2022

Last updated

Mar 21, 2023By the provider in NPPES

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Serve the People, Inc

  dba Serve the People Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Santa Ana, CA
  • NPI 1770803462
  Medicare reassignment

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

{
    "created_epoch": "1667520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1912614298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E 17TH ST STE 101",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927012641",
            "telephone_number": "714-352-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-04",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Moreno
• Juan Moreno
• Katherine Moreno
• Kaylina Anayse Moreno
• Maria Moreno
• Savannah Moreno, QASP-S
• Christian Moresco
• Gordon Morey
• Samantha Morey
• James Morgan, DNP

• Physician Assistant in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.