Song Moon, PA-C
NPI 1780019539 · Physician Assistant · Lackland Afb, TX
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Song Moon, PA-C is a Physician Assistant provider in Lackland Afb, TX (NPI 1780019539).
Provider details
- NPI number
- 1780019539
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- License
- PA18550 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Military Health Care Provider171000000X
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-09-12
- Last updated
- 2024-12-17
- Certified
- 2024-12-17
Frequently asked questions
- What is Song Moon's NPI number?
- Song Moon's National Provider Identifier (NPI) is 1780019539, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Song Moon's specialty?
- Song Moon is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Song Moon located?
- Song Moon's practice location on file with NPPES is 1100 Wilford Hall Loop Bldg 4554, Lackland Afb, TX 78236-5638.
- What is Song Moon's phone number?
- The practice phone number listed in the NPPES registry for Song Moon is (210) 292-1455.
- Does Song Moon accept Medicare?
- Song Moon is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Song Moon's NPI active?
- Yes — Song Moon's NPI (1780019539) is active in the NPPES registry as of the last update on 2024-12-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.