Noel Lena Moreno, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA20592 Issued in CA

Practice address

2633 Pacific Ave
Stockton, CA 95204-4429

Phone

(209) 944-5530

NPI assigned

Oct 16, 2009

Last updated

Oct 9, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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.

• Manshadi Heart Institute Inc

  • Interventional Cardiology Physician
  • Stockton, CA
  • NPI 1225380603
  Medicare reassignment
• San Joaquin Cardiology Medical Group Inc

  • Cardiovascular Disease Physician
  • Stockton, CA
  • NPI 1497785455
  Medicare reassignment

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1932434404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 MIDDLEFIELD AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 PACIFIC AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952044429",
            "telephone_number": "209-944-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "NOEL",
        "middle_name": "LENA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Gale Moreno, DDS
• Jonathan Moreno
• Marcus Robert Moreno
• Marissa Moreno
• Michael Robert Moreno, DDS
• Osvaldo Moreno
• Patricia Ann Moreno
• Raquel U Moreno, RD, CDE
• Serena E Moreno
• Sheila Rene Moreno

• Medical Physician Assistant in Stockton, CA
• Providers in Stockton, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.