Individual provider Active NPI

Patrick M Moore, M.D.

  • Surgery Physician
  • Murrieta, CA
National Provider Identifier
1194784025
Registry record updated Aug 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C53431 Issued in CA
Practice address
28078 Baxter Rd
Suite 420
Murrieta, CA 92563-1402
Phone
(951) 566-9370
Fax
(951) 200-4401
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD00032619 WA
Surgery Physician 208600000X C53431 CA Primary

Addresses

Primary practice location

28078 Baxter Rd
Suite 420
Murrieta, CA 92563-1402

Mailing address

29910 Murrieta Hot Springs Road
Suite G345
Murrieta, CA 92563-3814
Phone (951) 566-9370

Other identifiers 1

IdentifierTypeStateIssuer
C53431OtherCACALIFORNIA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20091125000375 CA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 7517052871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Colorectal Surgery (Proctology)
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

25405 Hancock Ave
Suite 217
Murrieta, CA 92562-5978
Phone (951) 477-5700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
025209WAMDNephrology Physician
C53431CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Surgical Specialists Surgery CurrentSince Mar 1, 2010 Accepting new patients
Patrick Moore MD Inc Surgery CurrentSince May 1, 2019 Accepting new patients
Mission Surgical Center Inc Past Accepting new patients

Locations

28078 Baxter Rd
Ste 420
Murrieta, CA 92563
Phone (951) 566-9370

29910 Murrieta Hot Springs Rd
Ste G345
Murrieta, CA 92563

25405 Hancock Ave
Ste 217
Murrieta, CA 92562
Phone (951) 200-2090

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

15611 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

36485 Inland Valley Dr
Wildomar, CA 92595
Phone (909) 677-9778

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: patrick.moore@3567.securemail.prognocis.com
  • Direct secure messaging: fmillwee182041@direct.llu.edu

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501545600000",
    "number": "1194784025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29910 MURRIETA HOT SPRINGS ROAD",
            "address_2": "SUITE G345",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925633814",
            "telephone_number": "951-566-9370",
            "fax_number": "951-200-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28078 BAXTER RD",
            "address_2": "SUITE 420",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631402",
            "telephone_number": "951-566-9370",
            "fax_number": "951-200-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PATRICK",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2017-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00032619",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "C53431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "C53431",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.