Individual provider Active NPI

Julie Catheryn Moede, PA-C

  • Physician Assistant
  • Roseville, CA
National Provider Identifier
1942312491
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17619 Issued in CA
Practice address
2 Medical Plaza Dr
Suite 130
Roseville, CA 95661-3043
Phone
(916) 865-1414
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA17619 CA Primary

Addresses

Primary practice location

2 Medical Plaza Dr
Suite 130
Roseville, CA 95661-3043

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other identifiers 1

IdentifierTypeStateIssuer
PA17619MedicaidCA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050323001425 CA Practitioner - Physician Assistant 6305892233 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

2800 L St
Sacramento, CA 95816-5616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA17619CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Physician Assistant CurrentSince Nov 17, 2014 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Nov 17, 2014 Accepting new patients
Cep America - California CurrentSince Mar 1, 2011 Accepting new patients
Mdstat Urgent Care, Inc Past Accepting new patients

Locations

6501 Coyle Ave
Carmichael, CA 95608
Phone (916) 537-5000

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

1650 Creekside Dr
Folsom, CA 95630
Phone (916) 983-7400

726 4th St
Marysville, CA 95901
Phone (530) 491-9491

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3 Medical Plaza Dr
Ste 140
Roseville, CA 95661
Phone (916) 781-1927

2 Medical Plaza Dr
Ste 130
Roseville, CA 95661
Phone (916) 782-7778

1 Medical Plaza Dr
Roseville, CA 95661
Phone (916) 781-1000

4001 J St
Sacramento, CA 95819
Phone (916) 453-4037

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

Interoperability endpoints

  • Direct secure messaging: jmoede39517@hisp.ehr.sutterhealth.org

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1942312491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEDICAL PLAZA DR",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613043",
            "telephone_number": "916-865-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEDE",
        "first_name": "JULIE",
        "middle_name": "CATHERYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA17619",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.