MICHAEL NICHOLAS MOULTON DO
NPI 1962907071
Internal Medicine - Cardiovascular Disease in Eglin Afb, FL

Q: What is Michael Moulton's NPI number?

The NPI number for Michael Moulton is 1962907071. It was assigned to this individual provider in the NPPES registry on March 29, 2018.

Q: What is Michael Moulton's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Moulton was last updated on August 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 March 29, 2018PECOS Enrolled

340 BOATNER RD, EGLIN AFB, FL 32542(850) 883-8600 Get Directions Write a Review

NPPES record last updated: August 19, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 19, 2024, May 17, 2024, Aug 10, 2023 and 2 more (5 updates tracked since 2018).

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About Michael Nicholas Moulton Do NPPES

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

MICHAEL NICHOLAS MOULTON DO (NPI 1962907071) is an individual cardiovascular disease provider in Eglin Afb, Florida, licensed in Maine (DO2072) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962907071

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameMICHAEL NICHOLAS MOULTONCredential: DO

Location Address340 BOATNER RDEglin Afb, FL 32542-1391

Mailing Address340 Boatner RdEglin Afb, FL 32542-1391 · (850) 883-8600

Phone(850) 883-8600

Sole ProprietorNo

Enumeration DateMarch 29, 2018

Last NPPES UpdateAugust 19, 20245 updates tracked since enumeration

NPPES CertifiedAugust 19, 2024

✔ NPI 1962907071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

License✔ Licensed in ME · DO2072

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal MedicineTaxonomy 207R00000X · License DO2972 (ME)

340 BOATNER RD, Eglin Afb, FL 32542

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Nicholas Moulton Do 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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Moulton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Conviva Specialty, LLC

497 mi

Cardiovascular Disease

12905 SW 42ND ST STE 103
Miami, FL 33175

Reassigned Medicare billing, Florida enrollment
48 clinicians in this Medicare group

NPI 1326498676 (786) 801-5620

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32542 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

$130.04 typical visit price

range $56.00 – $171.84

Typical copayment $32.51 (range $14.00 – $42.96)

Most-billed visit code 99204

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

Most-billed visit code 99213

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.

DR. ELISABETH HOPE WYNIA HWANG MD

Emergency Medicine