Timothy Glen Moore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 1490 Issued in FL

Practice address

1491 Governors Square Blvd
Tallahassee, FL 32301-3049

Phone

(850) 383-3322

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Capital Health Plan, Inc,

  • Health Maintenance Organization
  • Tallahassee, FL
  • NPI 1770688566
  Medicare reassignment NPD

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1083672190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15349",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323175349",
            "telephone_number": "850-383-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1491 GOVERNORS SQUARE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013049",
            "telephone_number": "850-383-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIMOTHY",
        "middle_name": "GLEN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 1490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.mooreod.p1@direct.capitalhealthplan.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1491 Governors Square Blvd",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323013049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mark C Moore, MD
• Melisa Moore, M.A.
• Michele M. Moore, RD, CDE
• Shannon Lori Moore, MS, R.D. LD/N
• Sharanda Moore
• Vivian S Moore, ARNP
• Francisco Ernesto Mora, M.D.
• Morales & Hall PL
• Alan Morales, MED., ATC/L
• Bryan Dan Morales, MD

• Optometrist in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.