EDUARDO DANIEL MORENO MANDUJANO (PA-C) – Physician Assistant, NPI 1144813890
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,430 PHYSICIAN ASSISTANT in GA
Provider Addresses for EDUARDO DANIEL MORENO MANDUJANO (PA-C)
331 Seminole Dr
Moultrie, GA 317689012
Phone: (229) 589-1962
Type: Location
2615 N MONROE ST STE 1
TALLAHASSEE, FL 323034027
Phone: (850) 558-6126
Fax: (850) 220-4461
Type: Location
PO BOX 1089
OMEGA, GA 317751089
Phone: (229) 589-1962
Type: Mailing
331 SEMINOLE DR
MOULTRIE, GA 317689012
Phone: (229) 589-1962
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2023-02-13
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 |
|---|---|---|---|---|
| I20230213001672 | I | Physician Assistant | FL | 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 |
|---|---|---|---|---|
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 46 | 23 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 31 | 31 | $0 |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 30 | 30 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 28 | 28 | $0 |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 26 | 26 | $0 |
Insurance plans in this area (ZIP 31768)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | GA | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | AL | |
| Nurse Practitioner | FL | |
| Physician Assistant | AL | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | AL | |
| - | AL | |
| - | AL | |
| - | AL |
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