Sidney Celine Moore, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1728 Dunlawton Ave Ste 5
Port Orange, FL 32127-2923

Phone

(386) 304-3404

NPI assigned

Oct 2, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Suncoast Vein & Vascular Clinic PLC

  • Vascular & Interventional Radiology Physician
  • Port Orange, FL
  • NPI 1750564696
  Medicare reassignment NPD
• Arjun D. Aneja, M.D., LLC

  • Specialist
  • Ormond Beach, FL
  • NPI 1285069559
  NPD

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774656000000",
    "number": "1194699199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 MILLENIA BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 DUNLAWTON AVE STE 5",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272923",
            "telephone_number": "386-304-3404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Clyde Morris Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Ormond Beach",
            "state": "FL",
            "postal_code": "321748179",
            "country_code": "US",
            "telephone_number": "386-304-3404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "385 Palm Coast Pkwy SW Unit 2",
            "address_purpose": "LOCATION",
            "city": "Palm Coast",
            "state": "FL",
            "postal_code": "321374784",
            "country_code": "US",
            "telephone_number": "386-304-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SIDNEY",
        "middle_name": "CELINE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-02",
        "last_updated": "2026-03-28",
        "certification_date": "2026-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moore & Menneto Chiropractic, PLLC
• Moore Chiropractic, PLLC
• Angela Leigh Moore, D.C.
• Cynthia Moore
• Katherine Rose Moore, PT, DPT
• Vijay J Moradia, MD
• Carla Cantinho Morales, LMHC
• Courtney Moreno
• Matthew Morgan
• Jamie L Morris Newcomb, DPT

• Physician Assistant in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2026; 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.

Verify at the official NPI Registry.