MR. CARLOS JULIO MORENO – Physician Assistant, NPI 1477615862
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,431 PHYSICIAN ASSISTANT in GA
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Provider Addresses for MR. CARLOS JULIO MORENO
690, Dallas Highway, Villa Rica, Carroll County, Georgia, 30180, United States
SUITE 101
VILLA RICA, GA 301801264
Phone: (770) 459-0620
Fax: (770) 456-7604
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 30 Open Payments records for all available years, with a total value of $821.
Total Amount is formed as General ($821) + Research ($0) + Ownership ($0) = $821.
Last reported payment date: 2024-09-26 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($350).
Total Amount
$821
General + Research + Ownership
Payments
30
Total payment records
General Amount
$821
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2012-01-18
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 |
|---|---|---|---|---|
| I20120118000417 | I | Physician 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 95117 | Professional service for multiple injections of allergen | 240 | 29 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 28 | 23 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 21 | 20 | $0 |
Insurance plans in this area (ZIP 30180)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Internal Medicine, Allergy/Immunology | GA | |
| A L L E R G Y/ I M M U N O L O G Y | GA | |
| Allergy/Immunology, Internal Medicine | FL | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA | |
| Allergy/Immunology, Pediatric Medicine | GA | |
| - | GA |
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