Michael Roy Moore, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD61324152 Issued in WA

Practice address

301 W Poplar St Ste 210
Walla Walla, WA 99362-2800

Phone

(509) 897-5788

NPI assigned

May 25, 2005

Last updated

May 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Michael Roy Moore Other name

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Physical Medicine and Rehabilitation

Education

Loma Linda University School of Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002
• Dayton General Hospital Hospital, Dayton, WA, CCN 501302
• St Anthony Hospital Hospital, Pendleton, OR, CCN 381319

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoore2505283@wm.providencedirect.org

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.

• Providence Health & Services - Washington

  dba Providence Medical Group Southeast Washington

  • Family Medicine Physician
  • Walla Walla, WA
  • NPI 1922259738
  Medicare reassignment Care Compare group NPD
• Redding Functional Restoration Program

  • Rehabilitation Practitioner
  • Redding, CA
  • NPI 1144399106
  NPD (past) Authorized official
• Portercare Adventist Health System

  dba Affiliated Ear, Nose & Throat Physicians

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1760761928
  NPD
• Portercare Adventist Health System

  dba AdventHealth Medical Group Urology at Lakewood

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD
• Providence Health & Services - Washington

  dba Poplar Medical Complex DME

  • Durable Medical Equipment & Medical Supplies
  • Walla Walla, WA
  • NPI 1174814552
  NPD (past)
• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  NPD (past)
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)
• Lee E. Vranna, M.D., Inc.

  • Rehabilitation Practitioner
  • Redding, CA
  • NPI 1174792741
  NPD (past)

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

• Columbia County Hospital District

  dba Columbia County Health System

  • Critical Access Hospital
  • Dayton, WA
  • NPI 1134128911
  Care Compare affiliation
• Providence Health & Services - Washington

  dba Providence St Mary Medical Center

  • General Acute Care Hospital
  • Walla Walla, WA
  • NPI 1386895886
  Care Compare affiliation
• Commonspirit Oregon

  dba St Anthony Hospital

  • Critical Access Hospital
  • Pendleton, OR
  • NPI 1649276734
  Care Compare affiliation

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1235132978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W POPLAR ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622858",
            "telephone_number": "095-897-8959",
            "fax_number": "095-897-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W POPLAR ST STE 210",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622800",
            "telephone_number": "509-897-5788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 10th Ave N",
            "address_purpose": "LOCATION",
            "city": "Billings",
            "state": "MT",
            "postal_code": "591010703",
            "country_code": "US",
            "telephone_number": "406-238-2759",
            "fax_number": "406-238-2723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD61324152",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CO",
            "license": "33095",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD61324152",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "G85748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "MOORE",
            "middle_name": "ROY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cloise Barton Moore, MD
• Janet Moore
• John Eric Moore, D.O.
• Kenneth E Moore, PA C
• Leigh Alison Moore, PHARM.D.
• Pat S Morales, MSN, RN, CPPN, CGRA
• Morasch Medical, PC (Heritage Clinic)
• Robert G. Morasch, M.D.
• Gloria Lucia Moreno
• Connie Kristina Morgan, MSPT

• Physical Medicine & Rehabilitation Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.