ANDREA MOON – Registered Nurse, NPI 1902209141

ANDREA MOON is a healthcare provider. based in Savannah, Georgia. specializing in NURSE PRACTITIONER. They hold a License No. RN124107 (GA). The NPI Number for ANDREA MOON is 1902209141

Main info

Female
4 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA MOON
NPI
1902209141
Phone
(912) 651-2253
Address
107 FAHM ST
Enumeration Date
2 October 2014
Last Update Date
2 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9126445200
Graduation Year
2022 (4 years ago)
PAC ID
0941671911
Group Practice PAC ID
1658367727
Professional Enrollment ID
I20230130002688
Address ID
GA314012391SA107XXBXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

9,658 NURSE PRACTITIONER in GA

Provider Addresses for ANDREA MOON

  • 107 FAHM ST

    B

    SAVANNAH, GA 314012391

    Phone: (912) 651-2253

    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 87 Open Payments records for all available years, with a total value of $4,179.

Total Amount is formed as General ($4,179) + Research ($0) + Ownership ($0) = $4,179.

Last reported payment date: 2024-09-05 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($2,656).

Total Amount

$4,179

General + Research + Ownership

Payments

87

Total payment records

General Amount

$4,179

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-05

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2023-01-30

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230130002688INurse PractitionerGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 31401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658367727View full group profile
NameSpecialtyState
-GA
Family PracticeGA
-GA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerWV
Family Practice, General PracticeGA

Reviews

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Frequently asked questions

Is ANDREA MOON listed with a National Provider Identifier?
Yes — ANDREA MOON has NPI 1902209141 on file in the registry.
Is ANDREA MOON still an active registrant?
ANDREA MOON carries an active NPI according to the public dataset.
What clinical focus is listed for ANDREA MOON?
At a glance, ANDREA MOON is tied to Registered Nurse. Clinical services aligned with this taxonomy classification.
What locale is associated with ANDREA MOON?
Directory geography for ANDREA MOON centers on Savannah, Georgia.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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