JENNIFER E. MOORE (PA) – Anesthesiologist Assistant, NPI 1275513830
Anesthesiologist Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,383 ANESTHESIOLOGY ASSISTANT in GA
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Provider Addresses for JENNIFER E. MOORE (PA)
Homegrown Orthodontics and Pediatric Dentistry, 405, Arrowhead Boulevard, Edgemoor Manor, Jonesboro, Clayton County, Georgia, 30236, United States
JONESBORO, GA 302361254
Phone: (770) 478-9877
Fax: (770) 478-2908
Type: Location
2455, Harrington Drive, Scottdale, DeKalb County, Georgia, 30033, United States
DECATUR, GA 300334903
Phone: (404) 315-6081
Type: Mailing
1984 PEACHTREE RD NW STE 515
ATLANTA, GA 303095219
Phone: (404) 351-1745
Fax: (404) 351-7121
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $58.
Total Amount is formed as General ($58) + Research ($0) + Ownership ($0) = $58.
Last reported payment date: 2024-08-21 • Largest payer in this snapshot: Medtronic, Inc. ($58).
Total Amount
$58
General + Research + Ownership
Payments
3
Total payment records
General Amount
$58
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-08-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Medtronic, Inc. | $58 |
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: 2004-10-27
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 |
|---|---|---|---|---|
| I20041027000577 | I | Anesthesiology Assistant | GA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30236)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ANESTHESIOLOGY ASSISTANT | GA | 36620 | Insertion of arterial catheter for blood sampling or infusion, accessed through the skin | 11 | 11 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| A N E S T H E S I O L O G Y | GA | |
| Anesthesiology Assistant | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Anesthesiology Assistant | GA | |
| A N E S T H E S I O L O G Y | FL | |
| Anesthesiology Assistant | GA | |
| A N E S T H E S I O L O G Y | GA | |
| Anesthesiology Assistant | AL | |
| Certified Registered Nurse Anesthetist (Crna) | GA |
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