JOHANNA L MOORE (PAC) – Physician Assistant, NPI 1730153438
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
9,691 PHYSICIAN ASSISTANT in PA
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Provider Addresses for JOHANNA L MOORE (PAC)
Wilmington Post Office, Chestnut Street, Wilmington, New Hanover County, North Carolina, 28405, United States
WILMINGTON, DE 19804
Phone: (800) 456-4629
Fax: (302) 224-2848
Type: Mailing
Bryn Mawr Avenue, Bryn Mawr, Youngstown, Mahoning County, Ohio, 44505, United States
BRYN MAWR, PA 19010
Phone: (610) 526-3583
Fax: (610) 526-3614
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $113.
Total Amount is formed as General ($113) + Research ($0) + Ownership ($0) = $113.
Last reported payment date: 2023-03-02 • Largest payer in this snapshot: Amgen Inc. ($113).
Total Amount
$113
General + Research + Ownership
Payments
1
Total payment records
General Amount
$113
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-03-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Amgen Inc. | $113 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-01-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040116000112 | I | Physician Assistant | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 29 | 29 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 26 | 25 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 25 | 25 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 23 | 21 | $0 |
Insurance plans in this area (ZIP 19804)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine, Family Practice | CA | |
| - | PA | |
| Emergency Medicine | PA | |
| Family Practice | NJ | |
| Physician Assistant | IL | |
| Physician Assistant | PA | |
| Family Practice | PA | |
| - | NJ | |
| Physician Assistant | PA | |
| Physician Assistant | PA |
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