DR. MICHAEL MOON M.D.
NPI 1619014230
Pain Medicine - Interventional Pain Medicine in San Diego, CA

Q: What is Michael Moon's NPI number?

The NPI number for Michael Moon is 1619014230. It was assigned to this individual provider in the NPPES registry on January 31, 2007.

Q: What is Michael Moon's specialty?

The primary specialty registered for this NPI is Pain Medicine, specializing in Interventional Pain Medicine, with taxonomy code 208VP0014X.

Q: When was this NPI record last updated?

The NPPES record for Michael Moon was last updated on September 24, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 31, 2007PECOS EnrolledAccepts Medicare AssignmentCLIA 05D2090549 · Waiver

5348 CARROLL CANYON RD, SUITE 101, SAN DIEGO, CA 92121(858) 202-1546(858) 202-1548 Get Directions Write a Review

NPPES record last updated: September 24, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Michael Moon M.d. NPPES

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

DR. MICHAEL MOON M.D. (NPI 1619014230) is an individual interventional pain medicine provider in San Diego, California, licensed in California (A61865) and active in the NPI registry since January 2007. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through January 25, 2027, and is a graduate of Loma Linda University School Of Medicine (1995).

NPPES Registry Identity

NPI1619014230

Entity TypeIndividualMale

Primary Taxonomy208VP0014X

Provider Legal NameDR. MICHAEL MOONCredential: M.D.

Location Address5348 CARROLL CANYON RD, SUITE 101San Diego, CA 92121-1733

Mailing Address5348 Carroll Canyon Rd, Suite 101San Diego, CA 92121-1733 · (858) 202-1546 · Fax (858) 202-1548

Phone(858) 202-1546

Fax(858) 202-1548

Sole ProprietorYes

Medical School CMSLoma Linda University School Of MedicineGraduated 1995

Enumeration DateJanuary 31, 2007

Last NPPES UpdateSeptember 24, 2012

✔ NPI 1619014230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPain Medicine · Interventional Pain MedicineAllopathic & Osteopathic Physicians

Taxonomy Code208VP0014X

License✔ Licensed in CA · A61865

Definition

Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment.

5348 CARROLL CANYON RD, San Diego, CA 92121

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Other Identifiers 9

OtherA61865CA · License Number

OtherP00302519CA · Rail Road Medicare

MedicaidGR0096070CA

Other330992123CA · Blue Cross

OtherZZZ07215ZCA · Blue Shield

Medicare PINWA61865ACA

Other127169100CA · Acs-us Dept Of Labor

Medicare UPINH16826CA

Other330992123CA · Tin

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

Dr. Michael Moon M.d. 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 ID7113936170

PECOS Enrollment IDI20060419000482

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.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2090549

Michael Moon, MD Amc · San Diego, CA

Active · expires Jan 25, 2027

CLIA Number05D2090549

Laboratory TypePhysician Office

Certificate Effective DateJanuary 26, 2025

Certificate Expiration DateJanuary 25, 2027

Laboratory DirectorDavid C. Majors, MD

Laboratory Phone(858) 202-1546

Laboratory LocationMichael Moon, MD Amc3939 Ruffin Rd #11, San Diego, CA 92123

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 8

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.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110

This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.

1,199 services48 patients

Therapy procedure using manual technique, each 15 minutes 97140

This therapy involves using hands-on techniques to help improve your body's movement and function. These techniques may include stretching, resistance exercises, or gentle pressure. Each session lasts 15 minutes and aims to relieve pain, promote healing, and improve your overall health.

1,191 services47 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

302 services62 patients

Evaluation for physical therapy, typically 30 minutes 97162

An evaluation for physical therapy is a 30-minute session where a physical therapist assesses your current physical condition. They'll examine your strength, flexibility, balance, and mobility to identify areas needing improvement. This helps tailor a therapy plan to your specific needs.

46 services41 patients

Re-evaluation for physical therapy, typically 20 minutes 97164

A re-evaluation for physical therapy is a 20-minute session where your progress is assessed. Your physical therapist will check your current condition, compare it to previous records, and adjust your treatment plan if needed. This ensures your therapy remains effective and tailored to your needs.

36 services25 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

17 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92121 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

$140.22 typical visit price

range $62.10 – $184.71

Typical copayment $35.05 (range $15.52 – $46.17)

Most-billed visit code 99204

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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 5

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

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