Individual provider Active NPI

Alexandra Moore, DO

  • Psychiatry Physician
  • Austin, TX
National Provider Identifier
1467075408
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
U2577 Issued in TX
Practice address
3501 Mills Ave
Austin, TX 78731-6391
Phone
(512) 324-2036
NPI assigned
May 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X U2577 TX Primary

Addresses

Primary practice location

3501 Mills Ave
Austin, TX 78731-6391

Mailing address

3501 Mills Ave
Austin, TX 78731-6309
Phone (512) 324-2036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230525001253 TX Practitioner - Psychiatry 3476919911 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U2577TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Springs Physician Group LLC Psychiatry CurrentSince May 12, 2023 Accepting new patients

Locations

1335 E Whitestone Blvd
#200
Cedar Park, TX 78613
Phone (512) 819-9400

700 SE Inner Loop
Georgetown, TX 78626
Phone (512) 351-8769

Interoperability endpoints

  • Direct secure messaging: alexandra.moore.1@8363.direct.athenahealth.com

Organizations & group practices 1

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": "1590451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1467075408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 MILLS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316309",
            "telephone_number": "512-324-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 MILLS AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316391",
            "telephone_number": "512-324-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALEXANDRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-26",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "U2577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.