Individual provider Active NPI

Tae Min Moon, DO

  • Family Medicine Physician
  • Newport News, VA
National Provider Identifier
1952096216
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102209363 Issued in VA
Practice address
10510 Jefferson Ave Ste a
Newport News, VA 23601-3102
Phone
(757) 594-3800
Fax
(757) 591-9021
NPI assigned
Apr 11, 2023
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 0102209363 VA Primary

Addresses

Primary practice location

10510 Jefferson Ave Ste a
Newport News, VA 23601-3102

Mailing address

10510 Jefferson Ave Ste a
Newport News, VA 23601-3102
Phone (757) 594-3800

Other practice location 1

332 Newtown Rd
Virginia Beach, VA 23462-1793
Phone (757) 473-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address VAExchange@patientfirstclinics.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250804002449 DC Practitioner - Family Practice 2466812441 Reassigns benefits to 1 organization
I20250813000183 VA Practitioner - Family Practice 2466812441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

332 Newtown Rd
Virginia Beach, VA 23462-1793
Phone (757) 473-8400

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
Patient First Richmond Medical Group PLLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

332 Newtown Rd
Virginia Beach, VA 23462
Phone (757) 473-8400

Interoperability endpoints

  • Direct secure messaging: tmoon216967@direct.rivhs.com
  • Direct secure messaging: vaexchange@patientfirstclinics.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1952096216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102",
            "telephone_number": "757-594-3800",
            "fax_number": "757-591-9021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10510 JEFFERSON AVE STE A",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013102",
            "telephone_number": "757-594-3800",
            "fax_number": "757-591-9021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "332 Newtown Rd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234621793",
            "country_code": "US",
            "telephone_number": "757-473-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "TAE",
        "middle_name": "MIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-11",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102209363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExchange@patientfirstclinics.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "332 Newtown Rd",
            "city": "Virginia Beach",
            "state": "VA",
            "country_code": "US",
            "postal_code": "234621793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.