JOSH CHARLES MOULIN (PA-C) – Physician Assistant, NPI 1053503458

JOSH CHARLES MOULIN (PA-C) is a healthcare provider. based in Holton, Kansas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. T01460 (KS). The NPI Number for JOSH CHARLES MOULIN (PA-C) is 1053503458

Main info

Male
Sole Proprietor
22 Years Of Experience
Name
JOSH CHARLES MOULIN (PA-C)
NPI
1053503458
Phone
(785) 364-2116
Address
1110 COLUMBINE DRIVE
Enumeration Date
10 August 2007
Last Update Date
30 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6205642548
Graduation Year
2004 (22 years ago)
PAC ID
0446342265
Group Practice PAC ID
5092627539
Professional Enrollment ID
I20071004000044
Address ID
KS675261452EL300XXAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:18State licenses:3Digital endpointsOther names

1,303 PHYSICIAN ASSISTANT in KS

Provider Addresses for JOSH CHARLES MOULIN (PA-C)

  • 1110 COLUMBINE DRIVE

    HOLTON, KS 66436

    Phone: (785) 364-2116

    Fax: (785) 364-9613

    Type: Mailing

  • Columbine Drive, Holton, Jackson County, Kansas, 66436, United States

    HOLTON, KS 664368824

    Phone: (785) 364-2126

    Fax: (785) 364-2801

    Type: Mailing

  • 300 N Park Ave

    Ellinwood, KS 675261452

    Phone: (620) 564-2548

    Fax: (620) 564-2491

    Type: Location

  • 721 W KANSAS

    GREENSBURG, KS 67054

    Phone: (620) 723-4217

    Fax: (620) 508-2067

    Type: Mailing

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 $44.

Total Amount is formed as General ($44) + Research ($0) + Ownership ($0) = $44.

Last reported payment date: 2024-08-26 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($28).

Total Amount

$44

General + Research + Ownership

Payments

3

Total payment records

General Amount

$44

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-08-26

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: 2007-10-04

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
I20071004000044IPhysician AssistantKSTBD

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 66436)

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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: 5092627539View full group profile
NameSpecialtyState
-KS
Family PracticeKS
-KS
Nurse PractitionerKS
Family PracticeKS
Family PracticeOK
Nurse PractitionerKS
Nurse PractitionerKS
Family PracticeKS
-KS

Reviews

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Frequently asked questions

What number should I use to identify JOSH CHARLES MOULIN (PA-C) for billing?
Administrative and clinical systems typically use NPI 1053503458 for JOSH CHARLES MOULIN (PA-C).
Is JOSH CHARLES MOULIN (PA-C) currently accepting referrals based on NPI status?
Registry metadata lists JOSH CHARLES MOULIN (PA-C) as active.
What services align with JOSH CHARLES MOULIN (PA-C)'s listing?
JOSH CHARLES MOULIN (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JOSH CHARLES MOULIN (PA-C) tied to Holton, Kansas?
If you are local to Holton, Kansas, JOSH CHARLES MOULIN (PA-C) may be relevant to your search.
Can I export JOSH CHARLES MOULIN (PA-C)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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