Shane Moore DPM PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

SHANE MOORE DPM PC

Practice address

865 S Watson Rd Ste 205
Buckeye, AZ 85326-3470

Phone

(623) 974-0522

Fax

(623) 933-5787

NPI assigned

Jun 20, 2025

Organization subpart

No

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

Authorized official

Name

Steven Shane Moore, DPMNPI 1306101571

Title

Owner

Phone

(480) 241-9848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shane Moore DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Peoria, AZ
  • NPI 1710470950

  1254673668

  Same PAC ID

Tax ID family

Shane Moore DPM PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shane Moore DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Peoria, AZ
  • NPI 1710470950
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Alliance Medical Specialists, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Buckeye, AZ
  • NPI 1902632664

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Shane Moore, DPM

  • Podiatrist
  • Peoria, AZ
  • NPI 1306101571
  NPD Authorized official
• Austin Rollins, DPM

  • Podiatrist
  • Buckeye, AZ
  • NPI 1912588377
  NPD (past)

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

{
    "created_epoch": "1750377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1255228490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE D1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814275",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 S WATSON RD STE 205",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263470",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE MOORE DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-20",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-241-9848",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.