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DR. SHAVON CHERELLE MOORE MD
NPI 1053682773
Psychiatry & Neurology - Child & Adolescent Psychiatry in San Diego, CA

Active since January 26, 2012PECOS EnrolledAccepts Medicare Assignment
200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: February 6, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 6, 2023, Sep 29, 2021, Jul 17, 2018 and 2 more (5 updates tracked since 2016).

About Dr. Shavon Cherelle Moore Md NPPES

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

DR. SHAVON CHERELLE MOORE MD (NPI 1053682773) is an individual child & adolescent psychiatry provider in San Diego, California, licensed in California (A152789) and active in the NPI registry since January 2012. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of University Of Nevada School Of Medicine (2016).

NPPES Registry Identity

NPI1053682773
Entity TypeIndividualFemale
Primary Taxonomy2084P0804X
Provider Legal NameDR. SHAVON CHERELLE MOORECredential: MD
Location Address200 W ARBOR DRSan Diego, CA 92103-9000
Mailing AddressPo Box 232410San Diego, CA 92193-2410
Phone(800) 926-8273
Fax(888) 539-8781
Sole ProprietorNo
Medical School CMSUniversity Of Nevada School Of MedicineGraduated 2016
Enumeration DateJanuary 26, 2012
Last NPPES UpdateFebruary 6, 20235 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2023
✔ NPI 1053682773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0804X
License✔ Licensed in CA · A152789
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License A152789 (CA)
200 W ARBOR DR, San Diego, CA 92103
Open in Google Maps ↗

Secondary Practice Location 1

Location 13020 Childrens WaySan Diego, CA 92123-4223 · Phone (858) 576-1700

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shavon Cherelle Moore Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2769733732
PECOS Enrollment IDI20181002000383
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Shavon Moore reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regents Of The University Of California
0.1 mi
Psychiatry
200 W ARBOR DR
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • 220 clinicians in this Medicare group
NPI 1508968967 (800) 926-8273
Family Health Centers Of San Diego Inc
0.2 mi
Federally Qualified Health Center (FQHC)
4094 4TH AVE
San Diego, CA 92103
  • Reassigned Medicare billing, California enrollment
  • 1,100 clinicians in this Medicare group
NPI 1629456900 (619) 515-2545
Community Research Foundation Inc
1.6 mi
Community/Behavioral Health
545 LAUREL ST
San Diego, CA 92101
  • Reassigned Medicare billing, California enrollment
  • 147 clinicians in this Medicare group
NPI 1225251812 (619) 233-4399

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

DR. RAMIN MOTARJEMI M.D.
Internal Medicine (Geriatric Medicine)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (858) 249-2500
DR. KYLE PALMER EDMONDS M.D., FAAHPM
Hospice, Inpatient
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
SHAWN RAVEENTH VEDAMANI MD
Anesthesiology
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DALE MICHAEL TRUJILLO NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
DR. EUGENE THOMAS RICHARDSON IV MD
Internal Medicine (Infectious Disease)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
KAYLEE PETERSEN ARNP
Nurse Practitioner (Psychiatric/Mental Health)
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
IRENE NEVAREZ NP
Nurse Practitioner
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (800) 926-8273
WILLIAM JAMES MOSS M.D.
Student in an Organized Health Care Education/Training Program
200 W ARBOR DR
SAN DIEGO, CA 92103
San Diego County (508) 395-4189

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 Shavon Moore's NPI number?

The NPI number for Shavon Moore is 1053682773. It was assigned to this individual provider in the NPPES registry on January 26, 2012.

Where is Shavon Moore located?

Shavon Moore practices at 200 W Arbor Dr, San Diego, CA 92103. The listed phone number is (800) 926-8273.

What is Shavon Moore's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Is Shavon Moore enrolled in Medicare?

Yes. Shavon Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Shavon Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shavon Moore reassigns Medicare benefits to 3 organizations: Regents Of The University Of California (San Diego, CA), Family Health Centers Of San Diego Inc (San Diego, CA) and Community Research Foundation Inc (San Diego, CA). Each 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 Shavon Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Shavon Moore was last updated on February 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.