Individual provider Active NPI

Daniel Leo Moon, M.D.

  • Surgery Physician
  • Arcadia, CA
National Provider Identifier
1922268705
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A101915 Issued in CA
Practice address
612 W Duarte Rd Ste 804
Arcadia, CA 91007-9250
Phone
(626) 600-2094
Fax
(626) 226-5827
NPI assigned
Jun 14, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A101915 CA Primary

Addresses

Primary practice location

612 W Duarte Rd Ste 804
Arcadia, CA 91007-9250

Mailing address

612 W Duarte Rd Ste 804
Arcadia, CA 91007-9250
Phone (626) 600-2094

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120921000191 CA Practitioner - General Surgery 8628226370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Asok Doraiswamy MD IncGroup PAC ID 7214156165, 6 clinicians

Practice addresses (Care Compare)

612 W Duarte Rd
Suite 804
Arcadia, CA 91007-9250
Phone (626) 600-2094

Hospital & facility affiliations

  • Usc Arcadia Hospital Hospital, Arcadia, CA, CCN 050238
  • Glendale Mem Hospital & HLTH Center Hospital, Glendale, CA, CCN 050058
  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A101915CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Asok Doraiswamy MD Inc Surgery CurrentSince Mar 15, 2016 Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Pasadena Hospital Association, LTD. Past Accepting new patients

Locations

612 W Duarte Rd
Ste 804
Arcadia, CA 91007
Phone (626) 247-1192

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

612 W Duarte Rd
Ste 801
Arcadia, CA 91007
Phone (626) 292-6899

1420 S Central Ave
Glendale, CA 91204
Phone (818) 502-1900

100 W California Blvd
Pasadena, CA 91105
Phone (626) 397-3445

438 W Las Tunas Dr
San Gabriel, CA 91776
Phone (626) 289-5454

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1922268705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 804",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079250",
            "telephone_number": "626-600-2094",
            "fax_number": "626-226-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 804",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079250",
            "telephone_number": "626-600-2094",
            "fax_number": "626-226-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "DANIEL",
        "middle_name": "LEO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-14",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A101915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.