Wistar Moore III, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

ME64685 Issued in FL

Practice address

1 Myrtlewood Dr
Savannah, GA 31405-1084

Phone

(352) 267-5190

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

Yes

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 FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wistar.moore.1@9582.direct.athenahealth.com

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.

• Florida Hospital Medical Group Inc

  dba AdventHealth Medical Group

  • Family Medicine Physician
  • Orlando, FL
  • NPI 1225034234
  Medicare reassignment NPD
• Florida Hospital Medical Group Inc

  dba Rothman Orthopaedics AdventHealth Medical Group at Minneola

  • Prosthetic/Orthotic Supplier
  • Minneola, FL
  • NPI 1285591545
  NPD
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308
  NPD
• Stuart Cardiovascular Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Stuart, FL
  • NPI 1366487878
  NPD
• Cardiovascular Surgeons, P.a.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Orlando, FL
  • NPI 1912904111
  NPD (past)
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Primary Care Clinic/Center
  • Pensacola, FL
  • NPI 1043261498
  NPD (past)
• Venice Cardiovascular Anesthesia Associates PLLC

  • Anesthesiology Physician
  • Venice, FL
  • NPI 1043253826
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1326076274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MYRTLEWOOD DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314051084",
            "telephone_number": "352-267-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MYRTLEWOOD DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314051084",
            "telephone_number": "352-267-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WISTAR",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME64685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375218600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latecka S Moore
• Lysbeth Irene Moore, MA., LPC
• Meghan Blevens Moore, OTR/L
• Riley Moore
• Stephanie Alice Moore, RD
• Zachary Kirk Moore, RN
• Jamie Moquin
• Jonathan Moquin
• Christine Marie Moran, R.D., L.D., M.A.
• Taylor Brooke Moran, MD

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.