MISS BONNIE LYNN MOON DNP
NPI 1508690603
Nurse Practitioner - Family in Culver City, CA

Q: What is Bonnie Moon's NPI number?

The NPI number for Bonnie Moon is 1508690603. It was assigned to this individual provider in the NPPES registry on August 29, 2024.

Q: What is Bonnie Moon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Bonnie Moon was last updated on June 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since August 29, 2024PECOS Enrolled

5901 GREEN VALLEY CIR STE 405, CULVER CITY, CA 90230(424) 266-7474 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Miss Bonnie Lynn Moon Dnp NPPES

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

MISS BONNIE LYNN MOON DNP (NPI 1508690603) is an individual family provider in Culver City, California, licensed in California (95031601) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS and maintains a secondary practice location in Culver City.

NPPES Registry Identity

NPI1508690603

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameMISS BONNIE LYNN MOONCredential: DNP

Location Address5901 GREEN VALLEY CIR STE 405Culver City, CA 90230-6971

Mailing Address100 Corporate Pointe Ste 270Culver City, CA 90230-8735 · (424) 266-7474 · Fax (310) 596-8268

Phone(424) 266-7474

Sole ProprietorNo

Enumeration DateAugust 29, 2024

Last NPPES UpdateJune 8, 2026

NPPES CertifiedJune 8, 2026

✔ NPI 1508690603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in CA · 95031601

5901 GREEN VALLEY CIR STE 405, Culver City, CA 90230

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Secondary Practice Location 1

Location 1200 Corporate Pointe Ste 50Culver City, CA 90230-8726 · Phone (424) 266-7474 · Fax (310) 596-8268

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Bonnie Lynn Moon Dnp 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90230 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

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

DR. KIM-THY HOANG NGUYEN DO

Family Medicine