Individual provider Active NPI

Sameet Moor, DO

  • Dermatology Physician
  • Fontana, CA
National Provider Identifier
1366964678
Registry record updated May 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
23084 Issued in CA
Practice address
16888 Baseline Ave
Fontana, CA 92336-2083
Phone
(855) 422-8029
NPI assigned
Jul 10, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R10992 TX
Family Medicine Physician 207Q00000X R10992 IA
Family Medicine Physician 207Q00000X 23084 CA
Dermatology Physician 207N00000X 23084 CA Primary

Addresses

Primary practice location

16888 Baseline Ave
Fontana, CA 92336-2083

Mailing address

903 W Martin St # Ms 49-2
San Antonio, TX 78207-0903
Phone (210) 358-0572

Other practice location 1

2055 Kimball Ave Ste 101
Waterloo, IA 50702-5047
Phone (319) 272-2112

Other practice location 2

903 W Martin St # MS 49-2
San Antonio, TX 78207-0903
Phone (201) 358-3650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, WA, TX, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20181009002421 IA Practitioner - Family Practice 6204100290 Reassigns benefits to 1 organization
I20230726003120 WA Practitioner - Family Practice 6204100290 Reassigns benefits to 1 organization
I20240627000976 TX Practitioner - Family Practice 6204100290 Reassigns benefits to 1 organization
I20251013001416 CA Practitioner - Family Practice 6204100290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity Physician Services PCGroup PAC ID 0749620888, 58 clinicians
Vituity Healthcare Services PCGroup PAC ID 2668812710, 27 clinicians
Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

16888 Baseline Ave
Fontana, CA 92336-2083
Phone (855) 422-8029

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

903 W Martin St
Ms 49 2
San Antonio, TX 78207-3110
Phone (210) 358-3441

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245
  • University Health System Hospital, San Antonio, TX, CCN 450213

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions18
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
23084CAMDDermatology Physician
R10992IAMDFamily Medicine Physician
R10992TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
Vituity Healthcare Services PC Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Community Medicine Associates Family Medicine CurrentSince Jun 18, 2024 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Vituity Physician Services PC Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Iowa Physicians Clinic Medical Foundation Family Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1499 E Highland Ave
Sn Bernrdno, CA 92404
Phone (855) 422-8029

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1825 Logan Ave
Ste 201
Waterloo, IA 50703

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779667200000",
    "number": "1366964678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST # MS 49-2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-0572",
            "fax_number": "210-358-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16888 BASELINE AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923362083",
            "telephone_number": "855-422-8029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Kimball Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Waterloo",
            "state": "IA",
            "postal_code": "507025047",
            "country_code": "US",
            "telephone_number": "319-272-2112",
            "fax_number": "319-272-2107",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "903 W Martin St # MS 49-2",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782070903",
            "country_code": "US",
            "telephone_number": "201-358-3650",
            "fax_number": "210-358-3799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOOR",
        "first_name": "SAMEET",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2026-05-25",
        "certification_date": "2026-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R10992",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "R10992",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "23084",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "23084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.