Individual provider Active NPI

Timothy David Moore, PA

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1679513071
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA01427 Issued in TX
Practice address
10425 Huffmeister Road Suite 320
Houston, TX 77065
Phone
(281) 955-2650
Fax
(281) 955-5875
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01427 TX
Surgical Physician Assistant 363AS0400X PA01427 TX Primary

Addresses

Primary practice location

10425 Huffmeister Road Suite 320
Houston, TX 77065

Mailing address

11800 FM 1960 Rd W
Houston, TX 77065-3840
Phone (281) 955-7577

Other practice location 1

22485 Tomball Pkwy Ste 2100
Houston, TX 77070-1560
Phone (281) 955-2650

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
I20050329000097 TX Practitioner - Physician Assistant 9436105947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

2635 W Baker Rd
Baytown, TX 77521-2206
Phone (281) 337-8550

7718 Garth Rd
Baytown, TX 77521-2206
Phone (713) 347-9031

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA01427TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Ortholonestar, PLLC CurrentSince Oct 1, 2020 Accepting new patients
Cypress Surgical Services, PLLC Surgical Past Accepting new patients

Locations

2635 W Baker Rd
Baytown, TX 77521
Phone (281) 337-8550

21212 Northwest Fwy
Ste 285
Cypress, TX 77429
Phone (281) 357-0661

20203 Bridgeland Creek Pkwy
Ste 200
Cypress, TX 77433
Phone (281) 955-2650

21212 Northwest Fwy
Ste 605
Cypress, TX 77429
Phone (281) 664-2102

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

7401 Main St
Houston, TX 77030
Phone (713) 799-8600

22485 Tomball Pkwy
Ste 2100
Houston, TX 77070
Phone (281) 664-2107

10425 Huffmeister Rd
Ste 320
Houston, TX 77065
Phone (281) 955-2650

11800 FM 1960 Rd W
Houston, TX 77065
Phone (281) 664-2102

11520 Northpointe Blvd
Tomball, TX 77377
Phone (281) 955-2650

Interoperability endpoints

  • Direct secure messaging: timothy.moore.1@15533.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1679513071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770653840",
            "telephone_number": "281-955-7577",
            "fax_number": "281-955-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10425 HUFFMEISTER ROAD SUITE 320",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77065",
            "telephone_number": "281-955-2650",
            "fax_number": "281-955-5875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22485 Tomball Pkwy Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770701560",
            "country_code": "US",
            "telephone_number": "281-955-2650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01427",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA01427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.