Johnathan M Moore, PA is a medicare enrolled "Physician Assistant" in Danielson, Connecticut. He graduated from nursing school in 2022 and has 4 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Day Kimball Medical Group Inc and 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
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and 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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| Experience | 4 Years |
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| Location | 55 Green Hollow Rd, Danielson, Connecticut |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Johnathan M Moore graduated from nursing school in 2022
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 |
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| 1467112250 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Day Kimball Medical Group Inc | 1557514411 | 91 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Johnathan M Moore allows following entities to bill medicare on his behalf.
| Entity Name | Day Kimball Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376813972
PECOS PAC ID: 1557514411
Enrollment ID: O20130102000091 |
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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 |
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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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