Johnathan M Moore, PA is a medicare enrolled "Physician Assistant" in Danielson, Connecticut. His current practice location is
55 Green Hollow Rd, Danielson, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 779-1865.
Johnathan M Moore is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1467112250.
Provider's Profile
Full Name | Johnathan M Moore |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 55 Green Hollow Rd, Danielson, Connecticut |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1467112250
- Provider Enumeration Date: 12/21/2021
- Last Update Date: 08/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 1254716673
- Enrollment ID: I20220920003169
Medical Identifiers
Medical identifiers for Johnathan M Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1467112250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnathan M Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Johnathan M Moore, PA 325 N James St Apt 2, Peekskill, NY 10566-2486 Ph: (401) 300-7652 | Johnathan M Moore, PA 55 Green Hollow Rd, Danielson, CT 06239-3533 Ph: (860) 779-1865 |
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