Individual provider Active NPI

Gaven Andrew Moore, PA-C

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1023821915
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004916A Issued in IN
Practice address
2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone
(812) 334-5081
NPI assigned
Jan 27, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10004916A IN
Physician Assistant 363A00000X 10004916A IN Primary

Addresses

Primary practice location

2651 E Discovery Pkwy
Bloomington, IN 47408-9059

Mailing address

1598 Church Camp Rd
Bedford, IN 47421-7483
Phone (812) 278-1552

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gmoore@direct.iuhealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250821000641 IN Practitioner - Physician Assistant 6608376033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10004916AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Sep 1, 2025 Accepting new patients
Iu Health Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant CurrentSince Sep 1, 2025 Accepting new patients

Locations

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: gmoore@direct.iuhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1023821915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1598 CHURCH CAMP RD",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474217483",
            "telephone_number": "812-278-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 E DISCOVERY PKWY",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474089059",
            "telephone_number": "812-334-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GAVEN",
        "middle_name": "ANDREW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10004916A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004916A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gmoore@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.