Stacey L S Moore, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1073412 Issued in OR

Practice address

2895 SE Powell Valley Rd
Gresham, OR 97080-1492

Phone

(971) 571-5319

NPI assigned

Dec 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rehab Specialists Outpatient LLCGroup PAC ID 6507254497, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rehab Specialists Outpatient, LLC

  • Clinic/Center
  • Milwaukie, OR
  • NPI 1952075962

  Occupational Therapist

  Medicare reassignment Care Compare group NPD
• Rehab Specialists Outpatient, LLC

  • Clinic/Center
  • Canby, OR
  • NPI 1437019015

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1558426593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12806 NE SAN RAFAEL ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972301826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2895 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970801492",
            "telephone_number": "971-571-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STACEY",
        "middle_name": "L S",
        "name_prefix": "Mrs.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC-009631",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OR",
            "license": "1073412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101847812 0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moon-Hart Psychotherapy & Consulting
• Eva Maria Moon, DMD
• Joni Marie Moon, PSY.D.
• Jessica Lynn Moore, BSN, RN
• Julia Erin Moore
• Angelica Morales
• Gabriela Morales
• Steven M Morales, D.D.S.
• Angela Moreno Villegas
• Leslie Fabiola Moreno

• Occupational Therapist in Gresham, OR
• Providers in Gresham, OR by specialty
• Occupational Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.