Shane Moore DPM PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0802 Issued in AZ

Legal business name

SHANE MOORE DPM PC

Practice address

13660 N 94TH Dr Ste D1
Peoria, AZ 85381-4275

Phone

(623) 974-0522

Fax

(623) 933-5787

NPI assigned

Jun 12, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Steven Shane Moore, DPMNPI 1306101571

Title

Owner

Phone

(480) 241-9848

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Shane Moore DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Buckeye, AZ
  • NPI 1255228490

  1254673668

  Same PAC ID

Tax ID family

Shane Moore DPM PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shane Moore DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Buckeye, AZ
  • NPI 1255228490
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Shane Moore, DPM

  • Podiatrist
  • Peoria, AZ
  • NPI 1306101571
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1710470950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE F1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814232",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 N 94TH DR STE D1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814275",
            "telephone_number": "623-974-0522",
            "fax_number": "623-933-5787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "490 W Bralliar Rd",
            "address_purpose": "LOCATION",
            "city": "Wickenburg",
            "state": "AZ",
            "postal_code": "853902448",
            "country_code": "US",
            "telephone_number": "623-974-0522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANE MOORE DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-241-9848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nimisha Darshak Shah, M.D.
• Rupal R Shah, B. PHARM
• Gobran Shahla
• Pourya Shahnaz, DMD
• Norman R. Shaia, M.D.
• Shannon Brown Counseling, PLLC
• Harold Shapiro
• Rahul Sharma, MD
• Quiarra Shaw- Gibson
• Thomas Shaw, PHARM.D.

• Foot & Ankle Surgery Podiatrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2025; 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.