Individual provider Active NPI

Braden J Moore, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Cleburne, TX
National Provider Identifier
1730475419
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2077 Issued in TX
Practice address
2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033-7435
Phone
(817) 556-3212
Fax
(817) 556-2388
NPI assigned
Jun 22, 2011
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 2077 TX
Foot & Ankle Surgery Podiatrist 213ES0103X 2077 TX Primary

Addresses

Primary practice location

2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033-7435

Mailing address

2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033-7435
Phone (817) 556-3212

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140723002570 TX Practitioner - Podiatry 6709002975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chisholm Trail Orthopedics and Sports Medicine, LLLPGroup PAC ID 7618916883, 13 clinicians

Practice addresses (Care Compare)

2010 W Katherine P Raines Rd
Suite 300
Cleburne, TX 76033-7447
Phone 8175563212201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue153
Removal of skin lesions23
Removal of nail tissue133
Removal or shaving of skin growth30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2077TXMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chisholm Trail Orthopedics & Sports Medicine, LLLP Podiatrist CurrentSince Jul 21, 2014 Accepting new patients
Chisholm Trail Orthopedics & Sports Medicine, LLLP CurrentSince Jul 21, 2014 Accepting new patients

Locations

2010 W Katherine P Raines Rd
Ste 300
Cleburne, TX 76033
Phone (817) 556-3212

5540 Sycamore School Rd
Ste 312
Ft Worth, TX 76123
Phone (817) 556-3212

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1730475419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD",
            "address_2": "STE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337435",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 W KATHERINE P RAINES RD",
            "address_2": "STE 300",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337435",
            "telephone_number": "817-556-3212",
            "fax_number": "817-556-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRADEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "2077",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

Verify at the official NPI Registry.