Kevin Matthew Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16479 Issued in TX

Practice address

448 Castroville Rd
San Antonio, TX 78207-5147

Phone

(210) 434-1400

Fax

(210) 431-7472

NPI assigned

Feb 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.moore@wellmed.eclinicaldirectplus.com

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.

• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1619673316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 CASTROVILLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075147",
            "telephone_number": "210-434-1400",
            "fax_number": "210-431-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 CASTROVILLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075147",
            "telephone_number": "210-434-1400",
            "fax_number": "210-431-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn Moore, L.AC.
• Katrina Margaret Moore, M.A., LPC
• Kayla Ann Moore
• Kaylin Marie Moore
• Kelsey Anne Moore
• Kiara Moore
• Lauren Brittany Moore, M.D.
• Lavon Rena Moore, NURSE
• Layne Rae Moore
• Magalie Moore, RN

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.