Kyle Anthony Moore, M.D.

Primary specialty

Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X

License

CA 043351 Issued in CA

Practice address

1313 Cutting Blvd
Richmond, CA 94804-2554

Phone

(510) 232-0874

Fax

(510) 232-8652

NPI assigned

Mar 27, 2007

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 CA

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

Specialty

General PracticeAlso: Internal Medicine

Education

University of Texas Medical School at Houston, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baart Community HealthcareGroup PAC ID 5799672515, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Baart Community Healthcare

  • Primary Care Clinic/Center
  • Los Angeles, CA
  • NPI 1497127328
  Medicare reassignment Care Compare group
• Addiction Research and Treatment, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Los Angeles, CA
  • NPI 1912045196
  NPD
• Baart Community Healthcare

  • Clinic/Center
  • La Puente, CA
  • NPI 1205267937
  NPD

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1568580322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70072",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948070072",
            "telephone_number": "510-375-0891",
            "fax_number": "510-232-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 CUTTING BLVD",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948042554",
            "telephone_number": "510-232-0874",
            "fax_number": "510-232-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KYLE",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "CA 043351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00433510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Moore Williams
• Carolyn Jo Moore
• Charles E. Moore, RASI
• Irene D Moore, MFTI
• Janae Patrice Moore
• Jessica Mora
• Maria Elena Morales
• Antonio Moran, O.D.
• Bridget Grace Moran, RNC, MSN, FNP
• Keila Moran

• Addiction Medicine (Internal Medicine) Physician in Richmond, CA
• Providers in Richmond, CA by specialty
• Addiction Medicine (Internal Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.
• 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.