Individual provider Active NPI

David Moore, NP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1669917662
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP132643 Issued in TX
Practice address
7219 Culebra Rd
San Antonio, TX 78251-1305
Phone
(210) 509-2603
Fax
(210) 334-2861
NPI assigned
Dec 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP132643 TX Primary

Addresses

Primary practice location

7219 Culebra Rd
San Antonio, TX 78251-1305

Mailing address

720 Pleasanton Rd
San Antonio, TX 78214-1306
Phone (210) 921-3800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170113002144 TX Practitioner - Nurse Practitioner 2466734058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Ancillary Services LTDGroup PAC ID 1456677087, 28 clinicians
GMG Health Systems Associates PAGroup PAC ID 8123932647, 115 clinicians

Practice addresses (Care Compare)

7219 Culebra Rd
San Antonio, TX 78251-1305
Phone (210) 509-2603

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132643TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Ancillary Services, LTD CurrentSince Jan 17, 2017 Accepting new patients
GMG Health Systems Associates PA CurrentSince Jan 3, 2017 Accepting new patients

Locations

7219 Culebra Rd
San Antonio, TX 78251
Phone (210) 509-2603

720 Pleasanton Rd
San Antonio, TX 78214

7616 Culebra Rd
Ste 130
San Antonio, TX 78251
Phone (210) 509-2603

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1669917662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 PLEASANTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782141306",
            "telephone_number": "210-921-3800",
            "fax_number": "210-334-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7219 CULEBRA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511305",
            "telephone_number": "210-509-2603",
            "fax_number": "210-334-2861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DAVID",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-29",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP132643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.