Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jonathan Moreno, PA

Individual provider Physician Assistant · NPI 1679128490

Jonathan Moreno, PA is a Physician Assistant in Forest, Virginia. Qualified in 2019, 7 years ago. Practices with Centra Medical Group LLC, a 717-clinician group and accepts Medicare assignment. Licensed in Virginia.

Years since qualifying
7
Licensed in
VA
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

16890 Forest Rd
Forest, VA 24551-4059
Phone: (434) 200-7210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110006885 (VA)

Record details

NPI number1679128490
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 8, 2019
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address16890 Forest Rd, Forest, VA 24551-4059

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Centra Medical Group Llc — 717 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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