Kevin M Moynihan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G78161 Issued in CA

Practice address

1901 W Kettleman LN
Suite 200
Lodi, CA 95242-4337

Phone

(209) 334-8540

Fax

(209) 368-2885

NPI assigned

Sep 13, 2006

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• American River Home Care Home health agency, Sacramento, CA, CCN 059665
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmoynihan40140@hisp.ehr.sutterhealth.org

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.

• Moynihan Family Practice

  • Family Medicine Physician
  • Carmichael, CA
  • NPI 1689210825
  NPD Authorized official
• Dignity Community Care

  • Home Health Agency
  • Woodland, CA
  • NPI 1851494231
  NPD (past)
• Lodi Memorial Hospital Association Inc

  • Rehabilitation Hospital Unit
  • Lodi, CA
  • NPI 1821028671
  NPD (past)
• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  NPD (past)
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  NPD (past)

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

• American River Home Care

  • Home Health Agency
  • Sacramento, CA
  • NPI 1811317811
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541721600000",
    "number": "1982709028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2545 E BIDWELL ST",
            "address_2": "STE 110",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956306443",
            "telephone_number": "916-983-8868",
            "fax_number": "916-983-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 W KETTLEMAN LN",
            "address_2": "SUITE 200",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952424337",
            "telephone_number": "209-334-8540",
            "fax_number": "209-368-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYNIHAN",
        "first_name": "KEVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G78161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G781610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zeyna Maria Mora
• Natali Morfin-Tapia, LCSW 107403
• Sami Moshi, MD
• Mountaintop Technology, Inc.
• George W Mowry, MD
• Jessica R Mueller, RD
• Kenneth H Mullen, MD
• Sheila Layah Mulvihill, M.A.
• Misty Dawn Munoz
• Demonte Louis Murray

• Family Medicine Physician in Lodi, CA
• Providers in Lodi, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2018; 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.