Victor Stephen Moore, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

19745 Issued in CA

Practice address

4791 E Palm Canyon Dr
Suite 200
Palm Springs, CA 92264-5220

Phone

(760) 834-7950

Fax

(760) 834-7951

NPI assigned

May 27, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

87.87 of 100Reported as group

Quality

85.37

Promoting interoperability

100

Improvement activities

40

Cost

74.18

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Medicare reassignment NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Cathedral City, CA
  • NPI 1629384615
  NPD
• Eisenhower Medical Center

  dba Eisenhower Health

  • General Acute Care Hospital
  • Palm Desert, CA
  • NPI 1912397290
  NPD
• Biofit Medical Corporation

  • Medical Specialty Clinic/Center
  • Palm Springs, CA
  • NPI 1528273695
  NPD (past)
• John D. Stansell, M.D., Inc

  • Primary Care Clinic/Center
  • Palm Springs, CA
  • NPI 1700811304
  NPD (past)

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1780842799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4791 E PALM CANYON DR",
            "address_2": "SUITE 200",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922645220",
            "telephone_number": "760-834-7950",
            "fax_number": "760-834-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4791 E PALM CANYON DR",
            "address_2": "SUITE 200",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922645220",
            "telephone_number": "760-834-7950",
            "fax_number": "760-834-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "VICTOR",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "19745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Jason Montijo
• Laurence Nicholas Moore, MD
• Shayana Nicole Moore, LVN
• Thomas Phillip Moore II, LPCC
• Timothy Robert Moore, L.C.S.W.
• Ryan Mopal, NP
• Laura Elma Morales
• Otilia Ramona Morales, MFTI,
• Patricia Morales
• Glen P Morehead, M.D.

• Medical Physician Assistant in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.