Tyler Moore, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

14156057-1206 Issued in UT

Practice address

1025 Medical Center Dr
Wilmington, NC 28401-7354

Phone

(910) 762-3882

NPI assigned

Jun 14, 2022

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 NC, UT2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utah Imaging Associates IncGroup PAC ID 1355394537, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017

Merit-based Incentive Payment System (MIPS)

Final score

83.57 of 100Reported as group

Quality

80.67

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

81.72 of 100Reported as group

Quality

88.57

Improvement activities

40

Cost

60.01

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: tmoore1061040@direct.novanthealth.org

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.

• Utah Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Farmington, UT
  • NPI 1629076229
  Medicare reassignment Care Compare group
• Delaney Radiologists Group PLLC

  • Specialist
  • Wilmington, NC
  • NPI 1912982166
  Medicare reassignment
• Delaney Radiologists PA

  • Specialist
  • Wilmington, NC
  • NPI 1902881147
  Medicare reassignment
• Scott E Southworth MD PC

  • Internal Medicine Physician
  • Bountiful, UT
  • NPI 1902977242
  NPD (past)
• South Summit Pediatrics. LLC

  • Legal Medicine
  • Draper, UT
  • NPI 1760490122
  NPD (past)
• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  NPD (past)
• Tanner Memorial Clinic

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham City Community Hospital, Inc.

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1982334751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 LEON DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589743",
            "telephone_number": "252-258-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017354",
            "telephone_number": "910-762-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TYLER",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14156057-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Alexander Moore III, M.D.
• Robert M. Moore, M.D.
• Shalane Beth Moore, NP-C
• Tammy Nicole Moore, M.D.
• Travis Moore, D.M.D.
• Yolonda Shevon Moore, MS, LCMHCA
• Charles Warren Moorehead, LCSWA
• Tyler Moorhouse
• Kelly Moran
• Marykate Morcerf, FNP-C

• Physician Assistant in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.