Richard Jay Moore, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G63467 Issued in CA

Practice address

63 Bovet Rd
# 406
San Mateo, CA 94402-3104

Phone

(650) 539-4224

Fax

(650) 292-2149

NPI assigned

May 4, 2006

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

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1992753040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BOVET RD",
            "address_2": "# 406",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023104",
            "telephone_number": "650-539-4224",
            "fax_number": "650-292-2149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BOVET RD",
            "address_2": "# 406",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023104",
            "telephone_number": "650-539-4224",
            "fax_number": "650-292-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RICHARD",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G63467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOG63467O",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassie Moody
• Tom D Mooney III, D.C.
• Candy Jo Moore
• David Dwight Moore Jr., D.D.S.
• Diana Moore, MA LMFT LPCC
• Victoria E. Moore, D.D.S.
• Anissa Teresa Moorewilliams, CADC I
• Poornima Moorthy
• Josefina Joan Mora
• Maria Del Carmen Morales Corrales, RN, PHN

• Internal Medicine Physician in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.