Individual provider Active NPI

George J Moore, LCSW

  • Clinical Social Worker
  • Fortuna, CA
National Provider Identifier
1245517895
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
93051 Issued in CA
Practice address
930 S Fortuna Blvd
Fortuna, CA 95540-3009
Phone
(707) 923-2783
NPI assigned
Nov 10, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082400 NY
Social Worker 104100000X 080335 NY
Clinical Social Worker 1041C0700X 93051 CA Primary

Addresses

Primary practice location

930 S Fortuna Blvd
Fortuna, CA 95540-3009

Mailing address

PO Box 769
Redway, CA 95560-0769
Phone (707) 923-2783

Other practice location 1

101 West Coast Rd
Redway, CA 95560
Phone (707) 923-2783

Other identifiers 2

IdentifierTypeStateIssuer
02994838OtherNYGRP MCD #
BA1047OtherGRP MCR #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150105001544 NY Practitioner - Clinical Social Worker 9739402421 Practice locations: Baldwinsville, NY
I20260326001948 CA Practitioner - Clinical Social Worker 9739402421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Redwoods Rural Health Center IncGroup PAC ID 6709867583, 13 clinicians

Practice addresses (Care Compare)

PO Box
Redway, CA 95560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
080335NYMDSocial Worker
93051CAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: george.moore.p1@direct.rrhc.nextgenshare.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1245517895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 769",
            "city": "REDWAY",
            "state": "CA",
            "postal_code": "955600769",
            "telephone_number": "707-923-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 S FORTUNA BLVD",
            "city": "FORTUNA",
            "state": "CA",
            "postal_code": "955403009",
            "telephone_number": "707-923-2783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 West Coast Rd",
            "address_purpose": "LOCATION",
            "city": "Redway",
            "state": "CA",
            "postal_code": "95560",
            "country_code": "US",
            "telephone_number": "707-923-2783",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GEORGE",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082400",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "080335",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MCD #",
            "identifier": "02994838",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MCR #",
            "identifier": "BA1047",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fortuna, CA

Sources for this page

Verify at the official NPI Registry.