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DR. BO HYUN MOON MD, MBA
NPI 1245125988
Student in an Organized Health Care Education/Training Program in Philadelphia, PA

Active since June 12, 2025PECOS Enrolled
10800 KNIGHTS RD, PHILADELPHIA, PA 19114(215) 612-5161 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Bo Hyun Moon Md, Mba NPPES

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

DR. BO HYUN MOON MD, MBA (NPI 1245125988) is an individual student in an organized health care education/training program in Philadelphia, Pennsylvania, licensed in Pennsylvania (MT235332) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1245125988
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. BO HYUN MOONCredential: MD, MBA
Location Address10800 KNIGHTS RDPhiladelphia, PA 19114-4200
Mailing Address10800 Knights RdPhiladelphia, PA 19114-4200
Phone(215) 612-5161
Sole ProprietorNo
Enumeration DateJune 12, 2025
NPPES CertifiedJune 11, 2025
✔ NPI 1245125988 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
License✔ Licensed in PA · MT235332
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.
10800 KNIGHTS RD, Philadelphia, PA 19114
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Bo Hyun Moon Md, Mba is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

MANSI SHETH DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
CHERYL LYNNE GEE-MAURER CRNP
Nurse Practitioner (Primary Care)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
HEATHER MOORE RN
Nurse Anesthetist, Certified Registered
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
IAN LUMSDEN PA-C
Surgery (Trauma Surgery)
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4064
PETER J GRELLA
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
DR. KRISHNA KOTHAMASU DO
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000
GRETCHEN DAWN OVERTON DPM
Student in an Organized Health Care Education/Training Program
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-5161
MS. BONNIE VITTI-HUOT PA-C
Physician Assistant
10800 KNIGHTS RD
PHILADELPHIA, PA 19114
Philadelphia County (215) 612-4000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bo Hyun Moon's NPI number?

The NPI number for Bo Hyun Moon is 1245125988. It was assigned to this individual provider in the NPPES registry on June 12, 2025.

Where is Bo Hyun Moon located?

Bo Hyun Moon practices at 10800 Knights Rd, Philadelphia, PA 19114. The listed phone number is (215) 612-5161.

What is Bo Hyun Moon's specialty?

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

Is Bo Hyun Moon enrolled in Medicare?

Yes. Bo Hyun Moon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Bo Hyun Moon was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.