Individual provider Active NPI

Michelle Moore, OTR

  • Occupational Therapist
  • Peoria, AZ
National Provider Identifier
1023274628
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
008034 Issued in AZ
Practice address
12679 W Desert Mirage Dr
Peoria, AZ 85383-3412
Phone
(719) 217-7822
NPI assigned
Aug 3, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 008034 AZ Primary

Addresses

Primary practice location

12679 W Desert Mirage Dr
Peoria, AZ 85383-3412

Mailing address

12679 W Desert Mirage Dr
Peoria, AZ 85383-3412
Phone (719) 217-7822

Other practice location 1

1255 N Arizona Ave Unit 1217
Chandler, AZ 85225-0710
Phone (602) 666-6620

Other practice location 2

279 Dolomite Dr
Colorado Springs, CO 80919-2207
Phone (719) 475-2943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260520002123 AZ Practitioner - Occupational Therapist in Private Practice 3870062748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capptcg, LLCGroup PAC ID 2668770157, 30 clinicians

Practice addresses (Care Compare)

1255 N Arizona Ave
Unit 1217
Chandler, AZ 85225-0710
Phone (602) 380-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008034AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Capptcg, LLC Single Specialty CurrentSince Mar 10, 2026 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1023274628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12679 W DESERT MIRAGE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833412",
            "telephone_number": "719-217-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12679 W DESERT MIRAGE DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833412",
            "telephone_number": "719-217-7822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 N Arizona Ave Unit 1217",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852250710",
            "country_code": "US",
            "telephone_number": "602-666-6620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "279 Dolomite Dr",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809192207",
            "country_code": "US",
            "telephone_number": "719-475-2943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHELLE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-03",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "008034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.