ANDREA JENAE MOSS – Speech-Language Pathologist, NPI 1720489107

ANDREA JENAE MOSS is a healthcare provider. based in Midvale, Utah. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold a License No. 9066300-4104 (UT). The NPI Number for ANDREA JENAE MOSS is 1720489107

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA JENAE MOSS
NPI
1720489107
Phone
(313) 671-4985
Address
7748 S ROPE KEY DR APT H208
Enumeration Date
4 September 2014
Last Update Date
8 February 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2487160937
Graduation Year
2014 (12 years ago)
PAC ID
5496975542
Group Practice PAC ID
2365718277
Professional Enrollment ID
I20250513001877
Address ID
MI483901295CO2500XPKWY300
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

87 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in UT

Provider Addresses for ANDREA JENAE MOSS

  • 7748 S ROPE KEY DR APT H208

    MIDVALE, UT 840477567

    Phone: (313) 671-4985

    Type: Mailing

  • 433 E 2700 S

    SALT LAKE CITY, UT 841153325

    Phone: (313) 671-4985

    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: 2025-05-13

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

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

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250513001877IQualified Speech Language PathologistMITBD

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 84047)

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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: 2365718277View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
-IL
Physical Therapist In Private PracticeNY
-MO
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIN
Physical Therapist In Private PracticeMI
Qualified Speech Language PathologistIN
-IL

Reviews

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Frequently asked questions

How do payers reference ANDREA JENAE MOSS?
For ANDREA JENAE MOSS, use NPI 1720489107 as the unique 10-digit identifier.
Is ANDREA JENAE MOSS shown as active in public data?
Registry records indicate ANDREA JENAE MOSS maintains an active NPI.
How would a patient describe ANDREA JENAE MOSS's focus?
For ANDREA JENAE MOSS, the primary taxonomy reads as Speech-Language Pathologist. Clinical services aligned with this taxonomy classification.
What locale is associated with ANDREA JENAE MOSS?
Directory geography for ANDREA JENAE MOSS centers on Midvale, Utah.
When was this NPI issued?
Enumeration for ANDREA JENAE MOSS is noted as September 4, 2014 where the registry provides it.

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