Kelly Anne Moffat, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1183 Issued in AZ

Practice address

5240 E Knight Dr
Ste 104
Tucson, AZ 85712-2122

Phone

(520) 795-4202

Fax

(520) 326-5317

NPI assigned

Oct 25, 2006

Last updated

Oct 19, 2007By the provider in NPPES

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cornea Associates, PLLCGroup PAC ID 3375530611, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.12 of 100Reported as group

Quality

90.32

Improvement activities

40

Cost

79.99

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cornea Associates, PLLC

  • Ophthalmology Physician
  • Tucson, AZ
  • NPI 1164516522
  Medicare reassignment Care Compare group
• Sean J. McCafferty, MD, PC

  • Ophthalmology Physician
  • Tucson, AZ
  • NPI 1316146574
  NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1972688695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR",
            "address_2": "STE 104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "520-795-4202",
            "fax_number": "520-326-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5240 E KNIGHT DR",
            "address_2": "STE 104",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122122",
            "telephone_number": "520-795-4202",
            "fax_number": "520-326-5317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "775249",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Modern Vascular of Tucson, LLC
• Manuel Modiano, M.D.
• John Modrzejewski, NP-C
• Jamie Michelle Moenster, D.O.
• Cody Moezzi
• Cheyenne Quinn Moffett, MD
• Sarah Virginia Moffett, PT
• Matthew Moffitt, PH.D.
• Gina Victor Farid Moftah
• Brianna Moga

• Optometrist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.