Individual provider Active NPI

Gabrielle Judith Moore

  • Optometrist
  • Hiawatha, KS
National Provider Identifier
1144162124
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2279 Issued in KS
Practice address
109 S 6TH St
Hiawatha, KS 66434-2306
Phone
(785) 742-3631
NPI assigned
Apr 8, 2026
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2279 KS Primary

Addresses

Primary practice location

109 S 6TH St
Hiawatha, KS 66434-2306

Mailing address

5225 NW 46TH St
Topeka, KS 66618-4402

Other practice location 1

4745 NW Hunters Ridge Cir Ste B
Topeka, KS 66618-2538
Phone (785) 246-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15933 Clayton Rd
Suite 210
Ballwin, MO 63011-2154

5225 NW 46TH St
Topeka, KS 66618-4402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2279KSMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Specialists of Atchison, LLC Past Accepting new patients

Organizations & group practices 1

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": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1144162124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 NW 46TH ST",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666184402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S 6TH ST",
            "city": "HIAWATHA",
            "state": "KS",
            "postal_code": "664342306",
            "telephone_number": "785-742-3631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4745 NW Hunters Ridge Cir Ste B",
            "address_purpose": "LOCATION",
            "city": "Topeka",
            "state": "KS",
            "postal_code": "666182538",
            "country_code": "US",
            "telephone_number": "785-246-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GABRIELLE",
        "middle_name": "JUDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "2279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, KS

Sources for this page

Verify at the official NPI Registry.