Individual provider Active NPI

Travis Moore, DPT

  • Physical Therapist
  • Lafayette, CA
National Provider Identifier
1699070946
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37428 Issued in CA
Practice address
3468 Mt Diablo Blvd Ste B110
Lafayette, CA 94549
Phone
(925) 284-6150
NPI assigned
Jan 18, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37428 CA Primary

Addresses

Primary practice location

3468 Mt Diablo Blvd Ste B110
Lafayette, CA 94549

Mailing address

450 Fensalir Ave
Pleasant Hill, CA 94523-1819

Other practice location 1

450 Fensalir Ave
Pleasant Hill, CA 94523-1819
Phone (209) 996-7098

Other practice location 2

3468 Mt Diablo Blvd Ste B110
Lafayette, CA 94549
Phone (925) 284-6150

Other practice location 3

68 Willow Rd
Menlo Park, CA 94025-3653
Phone (866) 839-6979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140317001597 CA Practitioner - Physical Therapist in Private Practice 4082845060 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Reach Physical Therapy, PC Current Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Mar 4, 2019 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

68 Willow Rd
Menlo Park, CA 94025
Phone (650) 691-8630

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.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1699070946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 FENSALIR AVE",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945231819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3468 MT DIABLO BLVD STE B110",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "94549",
            "telephone_number": "925-284-6150"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Fensalir Ave",
            "address_purpose": "LOCATION",
            "city": "Pleasant Hill",
            "state": "CA",
            "postal_code": "945231819",
            "country_code": "US",
            "telephone_number": "209-996-7098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3468 Mt Diablo Blvd Ste B110",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CA",
            "postal_code": "94549",
            "country_code": "US",
            "telephone_number": "925-284-6150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 Willow Rd",
            "address_purpose": "LOCATION",
            "city": "Menlo Park",
            "state": "CA",
            "postal_code": "940253653",
            "country_code": "US",
            "telephone_number": "866-839-6979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.