Individual provider Active NPI

Johanna Niroshini Moses, PA-C, MPH

  • Physician Assistant
  • Norman, OK
National Provider Identifier
1942540836
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2213 Issued in OK
Practice address
901 N Porter Ave
Norman, OK 73071-6404
Phone
(405) 307-1000
NPI assigned
Feb 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004725 VA
Physician Assistant 363A00000X 2213 OK Primary

Addresses

Primary practice location

901 N Porter Ave
Norman, OK 73071-6404

Mailing address

901 N Porter Ave
Norman, OK 73071-6404
Phone (405) 307-1000

Other practice location 1

100 Fairview Dr
Franklin, VA 23851-1238
Phone (405) 219-5320

Other names 1

  • Ms. Johanna Niroshini Ephraim Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, OK2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150409002202 VA Practitioner - Physician Assistant 6507184264 Reassigns benefits to 1 organization
I20170405002604 OK Practitioner - Physician Assistant 6507184264 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Healthcare Solutions, PLLCGroup PAC ID 7618255118, 18 clinicians

Practice addresses (Care Compare)

4220 N Classen Blvd
Suite a
Oklahoma City, OK 73118-2416
Phone (405) 768-5749

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0110-004725VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayview Physician Services, PC CurrentSince Jun 1, 2015 Accepting new patients
Immediate Care of Oklahoma, LLC CurrentSince Oct 17, 2018 Accepting new patients
Bayview Physician Services, PC CurrentSince Jun 1, 2015 Accepting new patients

Locations

11808 S May Ave
Oklahoma City, OK 73170
Phone (405) 735-2370

111 Mill Creek Pkwy
Chesapeake, VA 23323
Phone (757) 558-8210

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": "1362009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1942540836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716404",
            "telephone_number": "405-307-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PORTER AVE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716404",
            "telephone_number": "405-307-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Fairview Dr",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "VA",
            "postal_code": "238511238",
            "country_code": "US",
            "telephone_number": "405-219-5320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSES",
        "first_name": "JOHANNA",
        "middle_name": "NIROSHINI",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-28",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004725",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "2213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "EPHRAIM",
            "middle_name": "NIROSHINI",
            "prefix": "MS.",
            "credential": "PA-C, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.