Milton Rahmon Moore, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

P5691 Issued in TX

Practice address

2632 Broadway St Ste 201N
San Antonio, TX 78215-1145

Phone

(210) 226-0040

Fax

(210) 226-0050

NPI assigned

Jun 10, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Meharry Medical College School of Medicine, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Moore Dermatology PLLCGroup PAC ID 8628504628, 2 clinicians

Liv Medical Partners PLLCGroup PAC ID 5496119513, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Liv Medical Partners PLLC

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1639863533
  Medicare reassignment Care Compare group NPD Authorized official
• Moore Dermatology PLLC

  • Dermatology Physician
  • Houston, TX
  • NPI 1578312054
  Medicare reassignment Care Compare group NPD
• San Antonio Skin Care and Dermatology Clinic, PA

  • Dermatology Physician
  • San Antonio, TX
  • NPI 1326362054
  Medicare reassignment NPD
• Sonterra Dermatology PLLC

  • Specialist
  • San Antonio, TX
  • NPI 1285925966
  NPD
• Neil F Haddock MD PA

  • Specialist
  • San Antonio, TX
  • NPI 1215229992
  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1871888545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 2201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584287",
            "telephone_number": "210-496-5792",
            "fax_number": "210-496-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 BROADWAY ST STE 201N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782151145",
            "telephone_number": "210-226-0040",
            "fax_number": "210-226-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MILTON",
        "middle_name": "RAHMON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10039988",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P5691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Layne Rae Moore
• Magalie Moore, RN
• Maria L. Moore, COTA
• Mary A Moore, LCSW
• Mary S Moore, RN
• Patricia Ann Moore, PA-C
• Patrick Moore, D.D.S.
• Rebekah Moore, FNP-C
• Reginald Moore, M.D.
• Renaya Leigh Moore, RBT-22-229901

• Dermatology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.