Roger L. Moore, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1378 Issued in OK

Practice address

2929 S Garnett Rd
C/O Medcenter
Tulsa, OK 74129-5101

Phone

(918) 665-1520

Fax

(405) 749-4561

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St John Urgent Care Clinics IncGroup PAC ID 5890898084, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.51 of 100Reported as group

Quality

84.87

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• St John Urgent Care Clinics Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1003918830
  Medicare reassignment Care Compare group
• St. John Physicians, Inc.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1336194406
  Medicare reassignment NPD (past)
• Emergency Medicine Physicians of Tulsa County, LLC

  • Emergency Medicine Physician
  • Tulsa, OK
  • NPI 1003098773
  Medicare reassignment
• St. John Physicians, Inc

  • Rural Health Clinic/Center
  • Barnsdall, OK
  • NPI 1033176367
  NPD

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1295793099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22063",
            "address_2": "DEPT 0289",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741212063",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 S GARNETT RD",
            "address_2": "C/O MEDCENTER",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741295101",
            "telephone_number": "918-665-1520",
            "fax_number": "405-749-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROGER",
        "middle_name": "L.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200050070A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Cheyanne Moore
• Quanah Moore
• Rebecca Nichole Moore, APRN-CNP
• Robert Wade Moore
• Rodger Allen Moore, HIS, HADF
• Ruth E Moore, DO
• Shantoria Moore
• Stephanie Moore, CNS
• William Moore
• Terrell Dea Moorhead

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.