BOBBY MOORE DPT, PLLC
NPI 1003504317
Clinic/Center - Physical Therapy in Oklahoma City, OK
About Bobby Moore Dpt, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOBBY MOORE DPT, PLLC (NPI 1003504317), doing business as Sideout Sports Physical Therapy, is a healthcare organization registered as a physical therapy in Oklahoma City, Oklahoma and active in the NPI registry since April 2023. The organization lists Bobby Lee Moore, Physical Therapist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bobby Moore Dpt, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Bobby Moore Dpt, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bobby Moore Dpt, PLLC's NPI number?
The NPI number for Bobby Moore Dpt, PLLC is 1003504317. It was assigned to this organization in the NPPES registry on April 25, 2023. The provider is doing business as Sideout Sports Physical Therapy.
Where is Bobby Moore Dpt, PLLC located?
Bobby Moore Dpt, PLLC is located at 249 NW 71st Street, Oklahoma City, OK 73116. The listed phone number is (580) 364-3312.
What is Bobby Moore Dpt, PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Physical Therapy, with taxonomy code 261QP2000X.
Is Bobby Moore Dpt, PLLC enrolled in Medicare?
Yes. Bobby Moore Dpt, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bobby Moore Dpt, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Physical Therapist in Private Practice, reassign their Medicare billing to Bobby Moore Dpt, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Bobby Moore Dpt, PLLC accept?
Health plans from Blue Cross and Blue Shield of Oklahoma list Bobby Moore Dpt, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Bobby Moore Dpt, PLLC was last updated on October 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bobby Moore Dpt, Pllc · NPI 1003504317
Physical Therapy organization in Oklahoma City, Oklahoma. Organization record, active in the CMS NPPES registry since April 25, 2023.
## Identity
- **NPI:** 1003504317 (Entity type: Organization)
- **Enumerated:** April 25, 2023
- **Primary specialty:** Clinic/Center - Physical Therapy · taxonomy 261QP2000X
- **Also known as:** Sideout Sports Physical Therapy (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Bobby Moore, PHYSICAL THERAPIST
## Practice location
- **Address:** 249 NW 71ST STREET, Oklahoma City, OK 73116
- **Phone:** (580) 364-3312 · **Fax:** (405) 592-5297
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Physical Therapist in Private Practice) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 9, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1003504317) · Data from the CMS NPPES public registry.