Individual provider Active NPI

Patricia A Moran, MD

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1912937483
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60462003 Issued in WA
Practice address
9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172
Phone
(360) 253-6947
Fax
(360) 448-6324
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60462003 WA Primary

Addresses

Primary practice location

9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172

Mailing address

9430 NE Vancouver Mall Dr
Vancouver, WA 98662-6172
Phone (360) 253-6947

Other identifiers 2

IdentifierTypeStateIssuer
0019656MedicaidMT
000010961OtherMTBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141028000074 WA Practitioner - Family PracticePractitioner - Other (Physician) 3779476064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7915MTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Medical Center PS Family Medicine CurrentSince Aug 15, 2014 Accepting new patients
Belgrade Clinic PLLP Family Medicine Past Accepting new patients

Locations

9430 NE Vancouver Mall Dr
Vancouver, WA 98662
Phone (360) 253-6947

Interoperability endpoints

  • Direct secure messaging: patricia.moran.1@21026.direct.athenahealth.com

Organizations & group practices 2

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1912937483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9430 NE VANCOUVER MALL DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626172",
            "telephone_number": "360-253-6947",
            "fax_number": "360-448-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9430 NE VANCOUVER MALL DR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626172",
            "telephone_number": "360-253-6947",
            "fax_number": "360-448-6324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60462003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019656",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000010961",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.