Individual provider Active NPI

Thomas Glendon Moody, M.D.

  • Ophthalmology Physician
  • Tempe, AZ
National Provider Identifier
1003815705
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
09470 Issued in AZ
Practice address
2055 E Southern Ave
Suite a
Tempe, AZ 85282-7507
Phone
(480) 491-7676
Fax
(480) 491-7555
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 09470 AZ Primary

Addresses

Primary practice location

2055 E Southern Ave
Suite a
Tempe, AZ 85282-7507

Mailing address

2055 E Southern Ave
Suite a
Tempe, AZ 85282-7507
Phone (480) 491-7676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110407000858 MT Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 5991723744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9470AZMDChiropractor
09470AZMDOphthalmology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003815705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE",
            "address_2": "SUITE A",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-491-7676",
            "fax_number": "480-491-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTHERN AVE",
            "address_2": "SUITE A",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827507",
            "telephone_number": "480-491-7676",
            "fax_number": "480-491-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "THOMAS",
        "middle_name": "GLENDON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AZ",
            "license": "09470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

Verify at the official NPI Registry.