Jagadeesh K Moola, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD027960 Issued in PA

Practice address

503 N 21St St
Camp Hill, PA 17011-2204

Phone

(717) 763-2219

Fax

(717) 972-4844

NPI assigned

Jun 26, 2005

Last updated

Aug 20, 2020By the provider in NPPES

Sex

Male

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Specialty

Psychiatry

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Penn State Health Holy Spirit Medical Center Hospital, Camp Hill, PA, CCN 390004

Merit-based Incentive Payment System (MIPS)

Final score

82.85 of 100Reported as group

Quality

65.84

Promoting interoperability

100

Improvement activities

40

Cost

77

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/diakon/r4/
• Direct secure messaging: jmoola122072@direct.geisinger.edu

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.

• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment Care Compare group NPD
• Diakon Child, Family & Community Ministries

  • Community/Behavioral Health Agency
  • Williamsport, PA
  • NPI 1861802035
  Medicare reassignment NPD
• Diakon Child, Family & Community Ministries

  • Community/Behavioral Health Agency
  • Lewisburg, PA
  • NPI 1265842413
  NPD
• Diakon Child, Family and Community Ministries

  dba Diakon Family Life Service

  • Community/Behavioral Health Agency
  • Montoursville, PA
  • NPI 1467821207
  NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• Penn State Health Medical Group, LLC

  • Hospitalist Physician
  • Camp Hill, PA
  • NPI 1497409155
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Penn State Health Holy Spirit Medical Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Camp Hill, PA
  • NPI 1659566008

  Hospital

  Care Compare affiliation
• Penn State Health Holy Spirit Medical Center

  • General Acute Care Hospital
  • Camp Hill, PA
  • NPI 1881690212
  Care Compare affiliation

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

{
    "created_epoch": "1119744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1952307746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N 21ST ST",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170112204",
            "telephone_number": "717-763-2219",
            "fax_number": "717-972-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOLA",
        "first_name": "JAGADEESH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-26",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD027960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "232420975",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoola122072@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "503 N 21st St",
            "city": "Camp Hill",
            "state": "PA",
            "country_code": "US",
            "postal_code": "170112204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• MD Shahjahan Molla, MD
• Sarah Rose Monroe, RN
• Anthony Louis Montecalvo, M.D.
• Yvonne P Montes
• Joann Montz, RN
• Alexandra Renee Moore, LPC
• Amber Moore
• Courtney Moore, RN
• David Moore
• Helen Jane Moore, BA

• Psychiatry Physician in Camp Hill, PA
• Providers in Camp Hill, PA by specialty
• Psychiatry Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.