Individual provider Active NPI

Tiffany Dy Moore

  • Pediatrics Physician
  • Vestavia, AL
National Provider Identifier
1619364916
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35592 Issued in AL
Practice address
2409 Acton Rd Ste 171
Vestavia, AL 35243-2938
Phone
(205) 978-8249
NPI assigned
Apr 24, 2015
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35592 AL Primary

Addresses

Primary practice location

2409 Acton Rd Ste 171
Vestavia, AL 35243-2938

Mailing address

2409 Acton Rd Ste 171
Vestavia, AL 35243-2938
Phone (205) 217-1721

Other names 1

  • Ms. Tiffany Dy Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150924001190 AL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 2365750379

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35592ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. Past Accepting new patients
Acton Road Pediatrics, LLC Pediatrics PastSince Nov 7, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1619364916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 ACTON RD STE 171",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432938",
            "telephone_number": "205-217-1721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 ACTON RD STE 171",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432938",
            "telephone_number": "205-978-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIFFANY",
        "middle_name": "DY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-24",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "35592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "MOORE",
            "middle_name": "DY",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vestavia, AL

Sources for this page

Verify at the official NPI Registry.