NPIMap

Individual provider Active NPI

Trevor Dean Moore, PA

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1801594866
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2023006218 Issued in MO
Practice address
3801 S National Ave
Springfield, MO 65807-5210
Phone
(417) 269-6000
NPI assigned
Feb 20, 2023
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2023006218 MO Primary

Addresses

Primary practice location

3801 S National Ave
Springfield, MO 65807-5210

Mailing address

PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430

Other practice location 1

1423 N Jefferson Ave
Springfield, MO 65802-1917
Phone (417) 269-9812

Other practice location 2

525 Branson Landing Blvd
Branson, MO 65616-2052
Phone (417) 875-2627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230227000677 MO Practitioner - Physician Assistant 5395118111 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Mar 6, 2023 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jan 16, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Jan 16, 2024 Accepting new patients
Skaggs Community Hospital Association CurrentSince Jan 16, 2024 Accepting new patients
Lester E Cox Medical Centers Emergency Medicine CurrentSince Mar 6, 2023 Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

525 Branson Landing Blvd
Ste 100
Branson, MO 65616
Phone (417) 348-8646

2200 E Cleveland St
Monett, MO 65708
Phone (417) 236-2600

5100 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 269-2215

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

3801 S National Ave
Fl 5
Springfield, MO 65807

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1801594866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843",
            "telephone_number": "417-730-6430",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-269-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 N Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658021917",
            "country_code": "US",
            "telephone_number": "417-269-9812",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Branson Landing Blvd",
            "address_purpose": "LOCATION",
            "city": "Branson",
            "state": "MO",
            "postal_code": "656162052",
            "country_code": "US",
            "telephone_number": "417-875-2627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TREVOR",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-20",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2023006218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.