Individual provider Active NPI

Leslie Ann Moog, PA-S

  • Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1992287551
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11053 Issued in AZ
Practice address
10290 N 92ND St Ste 200
Scottsdale, AZ 85258-4528
Phone
(480) 905-2015
Fax
(480) 716-4347
NPI assigned
Aug 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 11053 AZ Primary

Addresses

Primary practice location

10290 N 92ND St Ste 200
Scottsdale, AZ 85258-4528

Mailing address

3650 Piper Street Ste a
Anchorage, AK 99508-4692
Phone (907) 339-9455

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250903003836 AZ Practitioner - Physician Assistant 4486067790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scottsdale Hip and Knee LLCGroup PAC ID 5193109254, 3 clinicians

Practice addresses (Care Compare)

10290 N 92ND St
Scottsdale, AZ 85258-4522
Phone (480) 905-2015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1992287551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 PIPER STREET STE A",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084692",
            "telephone_number": "907-339-9455",
            "fax_number": "907-339-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10290 N 92ND ST STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584528",
            "telephone_number": "480-905-2015",
            "fax_number": "480-716-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOG",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "PA-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "11053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.