Dennis Moore, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD61499857 Issued in WA

Practice address

1003 Wallace Way
Grandview, WA 98930-8805

Phone

(509) 203-1080

Fax

(509) 203-1077

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmoore3056663@wm.providencedirect.org

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.

• Prosser Public Hospital District of Benton County

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Medicare reassignment NPD
• Prosser Public Hospital District of Benton County

  • Specialist
  • Walla Walla, WA
  • NPI 1518770155
  NPD
• Prosser Public Hospital District of Benton County

  • Gastroenterology Physician
  • Prosser, WA
  • NPI 1780495978
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1053452250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-203-1080",
            "fax_number": "509-203-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WALLACE WAY",
            "city": "GRANDVIEW",
            "state": "WA",
            "postal_code": "989308805",
            "telephone_number": "509-203-1080",
            "fax_number": "509-203-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DENNIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "9907",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NV",
            "license": "NV 9907",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD61499857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay M McKie, PHARMD
• Erma Lus Medina, LCSW
• Ruby Medina, MSW
• Maria Carmen Mejia
• Marisol Meza, L.M.P.
• Petra Maria Morales, MSW
• Yadira Moran, BSW MS MENTAL HEALTH
• Eva Moreno
• Sandra Moreno, MSW, LICSW
• Daphne Morffi

• Pediatrics Physician in Grandview, WA
• Providers in Grandview, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.