Individual provider Active NPI

Trevena Moore, MD

  • Developmental - Behavioral Pediatrics Physician
  • Kansas City, KS
National Provider Identifier
1407893456
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
1299 Issued in VI
Practice address
2000 Olathe
Kansas City, KS 66160-8505
Phone
(913) 588-2746
Fax
(913) 274-3546
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2003012943 MO
Developmental - Behavioral Pediatrics Physician 2080P0006X 1299 VI Primary
Developmental - Behavioral Pediatrics Physician 2080P0006X 04-40273 KS

Addresses

Primary practice location

2000 Olathe
Kansas City, KS 66160-8505

Mailing address

2000 Olathe Blvd
Attn: Credentialing Office
Kansas City, KS 66160
Phone (913) 588-5746

Other practice location 1

4504 Estate Diamond Ste 3
Christiansted, VI 00820-5233
Phone (617) 306-2065

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drmoore@pccvi.com Direct

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181009003278 KS Practitioner - Pediatric Medicine 6002899564 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003012943MOMDPediatrics Physician
04-40273KSMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas University Physicians Inc Pediatrics CurrentSince Sep 11, 2018 Accepting new patients
Kansas University Physicians Inc CurrentSince Sep 11, 2018 Accepting new patients
Kansas University Physicians Inc Pediatrics Current Accepting new patients
Trevena B Moore, MD & Associates, PC Developmental - Behavioral Pediatrics Past Accepting new patients
Pediatric Care Center LLC Pediatrics Past Accepting new patients
Kansas University Physicians Inc Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

2000 Olathe
Ofc
Kansas City, KS 66160
Phone (913) 588-1908

2000 Olathe
Kansas City, KS 66160
Phone (913) 588-1908

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

Interoperability endpoints

  • Direct secure messaging: tmoore594769@direct.kuha.org

Organizations & group practices 6

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1407893456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 OLATHE BLVD",
            "address_2": "ATTN: CREDENTIALING OFFICE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "66160",
            "telephone_number": "913-588-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 OLATHE",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661608505",
            "telephone_number": "913-588-2746",
            "fax_number": "913-274-3546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4504 Estate Diamond Ste 3",
            "address_purpose": "LOCATION",
            "city": "Christiansted",
            "state": "VI",
            "postal_code": "008205233",
            "country_code": "US",
            "telephone_number": "617-306-2065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TREVENA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2003012943",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "VI",
            "license": "1299",
            "primary": true
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "KS",
            "license": "04-40273",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmoore@pccvi.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4504 Estate Diamond Ste 3",
            "city": "Christiansted",
            "state": "VI",
            "country_code": "US",
            "postal_code": "008205233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.