Lynn M Moreno, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110006449 Issued in VA

Practice address

2790 Godwin Blvd Ste 100
Suffolk, VA 23434-8151

Phone

(757) 983-8750

Fax

(757) 510-9442

NPI assigned

Mar 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Lynn M Lakoma Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  NPD

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1992047443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-983-8750",
            "fax_number": "757-510-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 GODWIN BLVD STE 100",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234348151",
            "telephone_number": "757-983-8750",
            "fax_number": "757-510-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-22",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110006449",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085004597",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085004597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LYNN",
            "last_name": "LAKOMA",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jala Moore
• Juanita Moore
• Margaret C Moore, RN
• Michelle Alicia Moore, LCSW
• Roshan Pradip Morbia, MD, FACS
• Anne E Morgan, DDS, M.D.
• Mokhtar O Morgan, MD
• Morning Glory Shuttle Services
• Lenny Ray Morris, PT
• Ryan Charles Morris, D.O.

• Physician Assistant in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.