ANDREW MOULTON
NPI 1164043626
Student in an Organized Health Care Education/Training Program in North Chicago, IL

Q: What is Andrew Moulton's NPI number?

The NPI number for Andrew Moulton is 1164043626. It was assigned to this individual provider in the NPPES registry on May 6, 2020.

Q: What is Andrew Moulton's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Moulton was last updated on May 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 06, 2020PECOS EnrolledAccepts Medicare Assignment

3333 GREEN BAY RD, NORTH CHICAGO, IL 60064(360) 930-2912 Get Directions Write a Review

NPPES record last updated: May 6, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Andrew Moulton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREW MOULTON (NPI 1164043626) is an individual student in an organized health care education/training program in North Chicago, Illinois and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS and is a graduate of R Franklin University Of Med & Sci/chicago Medical School (2021).

NPPES Registry Identity

NPI1164043626

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameANDREW MOULTON

Location Address3333 GREEN BAY RDNorth Chicago, IL 60064-3037

Mailing Address3333 Green Bay RdNorth Chicago, IL 60064-3037

Phone(360) 930-2912

Sole ProprietorNo

Medical School CMSR Franklin University Of Med & Sci/chicago Medical SchoolGraduated 2021

Enumeration DateMay 6, 2020

NPPES CertifiedMay 6, 2020

✔ NPI 1164043626 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

3333 GREEN BAY RD, North Chicago, IL 60064

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrew Moulton is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537523675

PECOS Enrollment IDI20240809003228, I20260402003672

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

78 services56 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

76 services76 patients

X-ray of foot, minimum of 3 views 73630

An X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.

48 services40 patients

Removal of noncancer thickened skin growth, 1 growth 11055

This procedure involves the removal of a thickened skin growth that is not cancerous. A healthcare professional will safely extract the growth, usually under local anesthesia. This process helps maintain skin health and prevent potential complications.

21 services17 patients

Removal of noncancer thickened skin growth, 2-4 growths 11056

This procedure involves the safe removal of 2-4 noncancerous thickened skin growths. It's typically done under local anesthesia. The process helps to alleviate discomfort and prevent potential complications. It's a standard, low-risk procedure.

21 services14 patients

Removal of fingernails or toenails, 6 or more nails 11721

This procedure involves the removal of six or more fingernails or toenails. It's typically done to treat severe nail infections, persistent pain, or abnormal nail growth. Local anesthesia is used to minimize discomfort. Healing usually takes a few weeks.

13 services13 patients

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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