Individual provider Active NPI

Richard Moore, MD

  • Surgery Physician
  • Orange, CA
National Provider Identifier
1023241015
Registry record updated Jan 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A123130 Issued in CA
Practice address
333 City Blvd. West - Suite 705
Orange, CA 92868-3298
Phone
(714) 456-5532
NPI assigned
Aug 25, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X A123130 CA Primary

Addresses

Primary practice location

333 City Blvd. West - Suite 705
Orange, CA 92868-3298

Mailing address

333 City Blvd. West - Suite 705
Orange, CA 92868-3298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160830001731 CA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 1052606035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of California, Irvine, California College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11550 Indian Hills Rd
Suite 310
Mission Hills, CA 91345-1203
Phone (818) 898-4900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A123130CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Michael Moore MD Apc Surgery CurrentSince Jul 18, 2016 Accepting new patients

Locations

11550 Indian Hls
Ste 310
Mission Hills, CA 91345
Phone (818) 898-4900

35 E Glenarm St
Pasadena, CA 91105
Phone (626) 768-4415

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388880000000",
    "number": "1023241015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD. WEST - SUITE 705",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 CITY BLVD. WEST - SUITE 705",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683298",
            "telephone_number": "714-456-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2014-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A123130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.