Individual provider Active NPI

Alvaro Moreno II, MD

  • Psychiatry Physician
  • Coeur d'Alene, ID
National Provider Identifier
1063603256
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
P7517 Issued in TX
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 625-4000
NPI assigned
Aug 5, 2007
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A147898 CA
Psychiatry Physician 2084P0800X M-16878 ID
Psychiatry Physician 2084P0800X P7517 TX Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone (800) 762-9244

Other practice location 1

701 Lewiston St
Cottonwood, ID 83522-9750
Phone (208) 962-3251

Other practice location 2

301 Cedar St
Orofino, ID 83544-9029
Phone (208) 476-5777

Other practice location 3

1768 Business Center Dr Ste 100
Reston, VA 20190-5359
Phone (800) 762-9244

Other identifiers 1

IdentifierTypeStateIssuer
4666397245OtherMYUTMB 4666397245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA, VA, NC, CA, IA6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20131024001826 TX Practitioner - PsychiatryPractitioner - Other (Physician) 6709011968 Reassigns benefits to 1 organization
I20241108001464 WA Practitioner - Psychiatry 6709011968 Reassigns benefits to 1 organization
I20241210000844 VA Practitioner - Psychiatry 6709011968 Reassigns benefits to 1 organization
I20250306003874 NC Practitioner - Psychiatry 6709011968 Reassigns benefits to 1 organization
I20250317000282 CA Practitioner - Psychiatry 6709011968 Reassigns benefits to 1 organization
I20250620000813 IA Practitioner - Psychiatry 6709011968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical Branch at Galveston, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Telecare PLLCGroup PAC ID 7810204831, 409 clinicians

Practice addresses (Care Compare)

736 Battlefield Blvd N
Chesapeake, VA 23320-4941
Phone (972) 449-0540

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A147898CAMDPsychiatry Physician
M-16878IDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients
Texana Center CurrentSince Jun 1, 2014 Accepting new patients
Helen Farabee Regional Centers Past Accepting new patients

Locations

4910 Airport Ave
Ste D
Rosenberg, TX 77471
Phone (281) 239-1300

Interoperability endpoints

  • Direct secure messaging: amoreno21757@direct.svmh.com
  • Direct secure messaging: amoreno57751@unitedregional.medalliesdirect.net
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/

Organizations & group practices 5

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1063603256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 100",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905359",
            "telephone_number": "800-762-9244",
            "fax_number": "786-672-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Lewiston St",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "ID",
            "postal_code": "835229750",
            "country_code": "US",
            "telephone_number": "208-962-3251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 Cedar St",
            "address_purpose": "LOCATION",
            "city": "Orofino",
            "state": "ID",
            "postal_code": "835449029",
            "country_code": "US",
            "telephone_number": "208-476-5777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1768 Business Center Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Reston",
            "state": "VA",
            "postal_code": "201905359",
            "country_code": "US",
            "telephone_number": "800-762-9244",
            "fax_number": "786-672-6006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ALVARO",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A147898",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ID",
            "license": "M-16878",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P7517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MYUTMB 4666397245",
            "identifier": "4666397245",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.