Provider Type Icon

DOUGLAS BERNARD MOORE PA-C NPI 1790853422


NPI Information

NPI: 1790853422
Provider Name: DOUGLAS BERNARD MOORE, PA-C
Classification: Physician Assistant - 363A00000X
Entity Type: Individual
Organization: TRA-MINW, PS

PECOS Registration: Yes

Address:
1304 FAWCETT AVE
SUITE 100
TACOMA, WA
ZIP 98402
Phone: (253) 761-4200
Get Directions

Douglas Bernard Moore, PA-C is a physician assistant in Tacoma, WA with 18 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Douglas Bernard Moore, PA-C NPI is 1790853422. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1304 FAWCETT AVE
SUITE 100
TACOMA, WA
ZIP 98402-911
Phone: (253) 761-4200
Fax: (253) 383-3553

The NPI 1790853422 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ultrasound guidance for accessing into blood vessel (HCPCS:76937)
  • Fluoroscopic guidance for insertion, replacement or removal of central venous access device (HCPCS:77001)
  • Insertion of central venous catheter and implanted device for infusion beneath the skin, patient 5 years or older (HCPCS:36561)
  • Insertion of central venous catheter for infusion, patient 5 years or older (HCPCS:36556)

The enumeration date for this NPI number is 12/1/2006 and was last updated on 1/31/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363A00000XPhysician AssistantPA10005095WASHINGTONYes
2363AM0700XPhysician AssistantMedicalPA10005095WASHINGTONNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18862654OTHERWASHINGTONMEDICARE PIN-UNION AVENUE OPEN MRI
28943157OTHERWASHINGTONLABOR AND INDUSTRIES CRIME VICTIMS-TRA
38951854OTHERWASHINGTONLABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
4G8946734MEDICARE PINWASHINGTON
58862652OTHERWASHINGTONMEDICARE PIN-TRA PIERCE
6P00428602OTHERWASHINGTONRR MEDICARE-TRA
70215666OTHERWASHINGTONLABOR AND INDUSTRIES-TRA
80249530OTHERWASHINGTONLABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
98862653OTHERWASHINGTONMEDICARE PIN-TRA KING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.