Individual provider Active NPI

Vicki P Moore, D.O.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Dallas, TX
National Provider Identifier
1023280039
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
N8427 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7057
Phone
(214) 456-7000
Fax
(214) 456-8132
NPI assigned
Mar 31, 2008
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N8427 TX
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X N8427 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7057

Mailing address

PO Box 845347
Dallas, TX 75284-7057
Phone (214) 456-7000

Other practice location 1

1451 Brush Creek Rd
Prosper, TX 75078-7057
Phone (214) 392-9664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110817000821 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6002085545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N8427TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Jul 11, 2011 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

1935 Medical District Dr
Ste EL171
Dallas, TX 75235

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1023280039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847057",
            "telephone_number": "214-456-7000",
            "fax_number": "214-456-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907057",
            "telephone_number": "214-456-7000",
            "fax_number": "214-456-8132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 Brush Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Prosper",
            "state": "TX",
            "postal_code": "750787057",
            "country_code": "US",
            "telephone_number": "214-392-9664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "VICKI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-31",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N8427",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "N8427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.