Samuel David Moore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

10654T Issued in CA

Practice address

1414 E Main St
Santa Maria, CA 93454-4806

Phone

(805) 925-2637

NPI assigned

Jun 13, 2006

Last updated

Dec 27, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA
• Direct secure messaging: samuel.moore@fhcn.eclinicaldirectplus.com

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.

• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Woodlake, CA
  • NPI 1164517744
  Medicare reassignment NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Pixley, CA
  • NPI 1033661558
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Delano, CA
  • NPI 1063283158
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Farmersville, CA
  • NPI 1326317819
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Goshen, CA
  • NPI 1336237072
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Springville, CA
  • NPI 1386738177
  NPD
• Family Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Terra Bella, CA
  • NPI 1831520048
  NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1881637445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 E MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544806",
            "telephone_number": "805-925-2637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 E MAIN ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544806",
            "telephone_number": "805-925-2637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10654T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMERC",
            "identifier": "1312330002",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debora Marie Moore, PA C
• Johanna Baran Moore, MD
• Joshua Moore, PT
• Katrina Lee Moore
• Mariah Moore
• Justin Mora, FNP
• Olivia Mora
• Victoria Mora, NP
• Beatriz Alicia Morales, LVN
• Desiree Morales

• Optometrist in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.