Individual provider Active NPI

Brian Lawrence Moore, MD

  • Obstetrics & Gynecology Physician
  • Merced, CA
National Provider Identifier
1992817472
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A87523 Issued in CA
Practice address
3349 G St Ste B
Merced, CA 95340-0978
Phone
(209) 349-8459
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A87523 CA Primary

Addresses

Primary practice location

3349 G St Ste B
Merced, CA 95340-0978

Mailing address

3349 G St Ste F
Merced, CA 95340-0978
Phone (209) 349-8459

Other practice location 1

315 Mercy Ave
Suite 400
Merced, CA 95340-8368
Phone (509) 564-3700

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040916000718 CA Practitioner - Obstetrics/Gynecology 7416924543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Indiana University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Timothy S Johnston MD PCGroup PAC ID 1456638238, 9 clinicians

Practice addresses (Care Compare)

3349 G St
Suite B
Merced, CA 95340-0978
Phone 20934984592245

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Merced, CA, CCN 050444

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A87523CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy S. Johnston, M.D. PC Current Accepting new patients
Merced OB GYN Care Inc Obstetrics & Gynecology Past Accepting new patients
Timothy S. Johnston, M.D. PC Past Accepting new patients
Golden Valley Health Center Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

3349 G St
Ste F
Merced, CA 95340
Phone (209) 349-8459

3349 G St
Ste B
Merced, CA 95340
Phone (209) 385-2240

333 Mercy Ave
Merced, CA 95340
Phone (209) 385-1280

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1992817472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 G ST STE F",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-349-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 G ST STE B",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400978",
            "telephone_number": "209-349-8459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Mercy Ave",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Merced",
            "state": "CA",
            "postal_code": "953408368",
            "country_code": "US",
            "telephone_number": "509-564-3700",
            "fax_number": "209-564-3799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIAN",
        "middle_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A87523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.