Active NPI
Richard Moreno, PH.D.
- Clinical Psychologist
- Plano, TX
National Provider Identifier
1073665931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 24453
- Practice address
- 1721 W Plano Pkwy
Suite 107
Plano, TX 75075-8634 - Phone
- (972) 673-4111
- Fax
- (972) 578-8397
- NPI assigned
- Jan 18, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 24453 | TX | Primary |
Addresses
Primary practice location
1721 W Plano Pkwy
Suite 107
Plano, TX 75075-8634
Mailing address
110 S Bradley St
McKinney, TX 75069-4509
Phone (972) 673-4111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0022LV | Other | TX | BLUE CROSS BLUE SHIELD |
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050203000742 | TX | Practitioner - Clinical Psychologist | 2365493681 | Practice locations: Plano, TX |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1721 W Plano Pkwy
Suite 107
Plano, TX 75075-8633
Phone (972) 673-4111
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24453 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073665931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 S BRADLEY ST",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750694509",
"telephone_number": "972-673-4111",
"fax_number": "972-578-8397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 W PLANO PKWY",
"address_2": "SUITE 107",
"city": "PLANO",
"state": "TX",
"postal_code": "750758634",
"telephone_number": "972-673-4111",
"fax_number": "972-578-8397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "24453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0022LV",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- 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.