Individual provider Active NPI

Ronald Jason Moore, PA-C

  • Surgical Physician Assistant
  • Celebration, FL
National Provider Identifier
1316902679
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
13064 Issued in GA
Practice address
400 Celebration PL
Celebration, FL 34747-4970
Phone
(352) 598-4469
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9102945 FL
Surgical Physician Assistant 363AS0400X PA9102945 FL
Surgical Physician Assistant 363AS0400X 13064 GA Primary
Physician Assistant 363A00000X PA9102945 FL

Addresses

Primary practice location

400 Celebration PL
Celebration, FL 34747-4970

Mailing address

917 SE 9TH Ave
Ocala, FL 34471-3849
Phone (352) 598-4469

Other practice location 1

3310 Waterman Way
Tavares, FL 32778-5250
Phone (352) 343-1216

Other practice location 2

700 Doctors Ct
Leesburg, FL 34748-7314
Phone (352) 787-9838

Other identifiers 5

IdentifierTypeStateIssuer
292533800MedicaidFL
Y04L4OtherFLBCBS OF FL
P00414081OtherFLRR MEDICARE
P00702090OtherFLRR MEDICARE
U4075OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20050125000560 FL Practitioner - Physician Assistant 5698725919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

400 Celebration PL
Celebration, FL 34747-4970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Mar 2, 2020 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Mar 2, 2020 Accepting new patients
Venice Cardiovascular Associates PL PastSince Jul 12, 2004 Accepting new patients
Stuart Cardiovascular Anesthesia Associates PLLC PastSince Jul 31, 2006 Accepting new patients
Venice Cardiovascular Anesthesia Associates PLLC Past Accepting new patients

Locations

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

3310 Waterman Way
Tavares, FL 32778
Phone (352) 343-1216

3120 Waterman Way
Tavares, FL 32778
Phone (352) 253-3251

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: rmoore71917@adventhealth.direct-ci.com

Organizations & group practices 5

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1316902679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 SE 9TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344713849",
            "telephone_number": "352-598-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "352-598-4469"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3310 Waterman Way",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327785250",
            "country_code": "US",
            "telephone_number": "352-343-1216",
            "fax_number": "352-343-1582",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 Doctors Ct",
            "address_purpose": "LOCATION",
            "city": "Leesburg",
            "state": "FL",
            "postal_code": "347487314",
            "country_code": "US",
            "telephone_number": "352-787-9838",
            "fax_number": "352-622-5771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RONALD",
        "middle_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9102945",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9102945",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "13064",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102945",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292533800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "Y04L4",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00414081",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00702090",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "U4075",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

Verify at the official NPI Registry.