Lauren Charlie Moreno, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

6136 Issued in AZ

Practice address

926 E McDowell Rd Ste 202
Phoenix, AZ 85006-2508

Phone

(602) 609-4525

Fax

(623) 584-7194

NPI assigned

Oct 7, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Park Health CenterGroup PAC ID 8325949647, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1558308825
  Medicare reassignment Care Compare group NPD
• Clinica la Familia, PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1780668921
  Medicare reassignment
• Mountain Park Health Center

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1386452415
  NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)
• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)

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

{
    "created_epoch": "1444176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1932579620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203",
            "fax_number": "702-838-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 E MCDOWELL RD STE 202",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062508",
            "telephone_number": "602-609-4525",
            "fax_number": "623-584-7194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7734 N 59th Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "85301",
            "country_code": "US",
            "telephone_number": "602-569-3999",
            "fax_number": "602-569-3887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "LAUREN",
        "middle_name": "CHARLIE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-07",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "6136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "074174",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edna Moreno, BS SLP
• Heather Ann Moreno
• Jaysen Eduardo Moreno, AU.D.
• Jazmin Moreno, PHARM.D.
• Karen Thao Moreno
• Lisa Moreno, MSW
• Maribel Moreno, LPN
• Michele Lee Moreno
• Nancine Moreno, LPN
• Olivia Moreno, RN

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.