Marc Wayne Moore, M.P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5048 Issued in AZ

Practice address

2500 S Power Rd
Ste 123
Mesa, AZ 85209-6686

Phone

(480) 218-1344

Fax

(480) 218-1356

NPI assigned

Jun 10, 2005

Last updated

Jul 18, 2024By the provider in NPPES

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 AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moore Physical Therapy PLCGroup PAC ID 6103815212, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Moore Physical Therapy PLC

  • Physical Therapist
  • Mesa, AZ
  • NPI 1538258991
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1578567129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S POWER RD",
            "address_2": "STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096686",
            "telephone_number": "480-218-1344",
            "fax_number": "480-218-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S POWER RD",
            "address_2": "STE 123",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096686",
            "telephone_number": "480-218-1344",
            "fax_number": "480-218-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARC",
        "middle_name": "WAYNE",
        "credential": "M.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706210",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Moore
• Haylee Moore, RN
• Jason Moore, PT, DPT
• Kevin Deandre Moore
• M Kent Moore, M.D.
• Melanie L Moore, AU.D.
• Michelle Marie Moore
• Nicole Marie Moore
• Seger Moore
• Vanessa Kaitlyn Moore, RBT

• Orthopedic Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.