RANDY RANSHAWN MOORE PA-C
NPI 1053627265
Physician Assistant in Longview, TX

Q: What is Randy Moore's NPI number?

The NPI number for Randy Moore is 1053627265. It was assigned to this individual provider in the NPPES registry on August 25, 2010.

Q: What is Randy Moore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Randy Moore was last updated on August 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since August 25, 2010PECOS Enrolled

425 N FREDONIA ST, LONGVIEW, TX 75601(903) 758-2610(903) 758-7081 Get Directions Write a Review

NPPES record last updated: August 26, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 12, 2024, Nov 15, 2023, Oct 7, 2022 (3 updates tracked since 2022).

On this page

About Randy Ranshawn Moore Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RANDY RANSHAWN MOORE PA-C (NPI 1053627265) is an individual physician assistant in Longview, Texas, licensed in Texas (PA07050) and active in the NPI registry since August 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053627265

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameRANDY RANSHAWN MOORECredential: PA-C

Location Address425 N FREDONIA STLongview, TX 75601-6464

Mailing Address1107 E Marshall AveLongview, TX 75601-5602 · (903) 758-2610 · Fax (903) 758-7081

Phone(903) 758-2610

Fax(903) 758-7081

Sole ProprietorNo

Enumeration DateAugust 25, 2010

Last NPPES UpdateAugust 26, 20253 updates tracked since enumeration

NPPES CertifiedAugust 26, 2025

✔ NPI 1053627265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in TX · PA07050

Definition

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.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA07050 (TX)

Also ListedPhysician Assistant · SurgicalTaxonomy 363AS0400X · License PA07050 (TX)

425 N FREDONIA ST, Longview, TX 75601

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, CHRISTUS Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Randy Ranshawn Moore Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75601 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$68.55 typical visit price

range $17.52 – $136.11

Typical copayment $17.13 (range $4.38 – $34.02)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRYSTAL KELLI FETTING LCDC

Counselor (Addiction (Substance Use Disorder))