Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALICE GAIL MOON MSRD, PAC
NPI 1790724011
Dietitian, Registered in Livonia, MI

Q: What is Alice Moon's NPI number?

The NPI number for Alice Moon is 1790724011. It was assigned to this individual provider in the NPPES registry on June 5, 2006.

Q: What is Alice Moon's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Q: When was this NPI record last updated?

The NPPES record for Alice Moon was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 43 days 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 June 05, 2006PECOS EnrolledAccepts Medicare Assignment

20010 FARMINGTON RD, LIVONIA, MI 48152(248) 471-7171(248) 471-1212 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 13, 2026, Sep 11, 2025 (2 updates tracked since 2025).

On this page

About Alice Gail Moon Msrd, Pac NPPES

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

ALICE GAIL MOON MSRD, PAC (NPI 1790724011) is an individual dietitian, registered in Livonia, Michigan, licensed in Michigan (577469) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1790724011

Entity TypeIndividualFemale

Primary Taxonomy133V00000X

Provider Legal NameALICE GAIL MOONCredential: MSRD, PAC

Location Address20010 FARMINGTON RDLivonia, MI 48152-1408

Mailing Address20010 Farmington RdLivonia, MI 48152-1408 · (248) 471-7171 · Fax (248) 471-1212

Phone(248) 471-7171

Fax(248) 471-1212

Sole ProprietorNo

Medical School CMSOtherGraduated 1995

Enumeration DateJune 5, 2006

Last NPPES UpdateJuly 13, 20262 updates tracked since enumeration

✔ NPI 1790724011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers

Taxonomy Code133V00000X

License✔ Licensed in MI · 577469

Definition

A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.

Also ListedPhysician AssistantTaxonomy 363A00000X · License 5601002478 (MI)

20010 FARMINGTON RD, Livonia, MI 48152

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Alice Gail Moon Msrd, Pac 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 ID42226433

PECOS Enrollment IDI20060222000313

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 2

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 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.

46 services19 patients

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.

32 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48152 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

$0.00 typical visit price

range $58.04 – $177.36

Typical copayment $0.00 (range $14.51 – $44.34)

Most-billed visit code NA

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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 20

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

DONALD WILLIAM BOOTH MSW, CSW, ACSW

Social Worker (Clinical)