DR. JOHN ERIC MOORE D.O.
NPI 1063412070
Family Medicine in Walla Walla, WA
About Dr. John Eric Moore D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN ERIC MOORE D.O. (NPI 1063412070) is an individual family medicine provider in Walla Walla, Washington, licensed in Virginia (01022001116) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, maintains a secondary practice location in Murrieta, and is a graduate of Nova Southeastern College Of Osteo Medicine (1998).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
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. John Eric Moore D.o. 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.
Medicare Billing Reassignment
Medicare enrollment records show John Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Vancouver, WA 98661
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Bristol Bay Area Health Corporation
- 360 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 99362 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
WALLA WALLA, WA 99362
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 John Moore's NPI number?
The NPI number for John Moore is 1063412070. It was assigned to this individual provider in the NPPES registry on August 1, 2005.
Where is John Moore located?
John Moore practices at 55 W Tietan St, Walla Walla, WA 99362. The listed phone number is (509) 525-3720.
What is John Moore's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is John Moore enrolled in Medicare?
Yes. John 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 organization bills Medicare for John Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Moore reassigns Medicare benefits to Cowlitz Indian Tribe (Vancouver, WA). The 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 John 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 John Moore was last updated on March 25, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Dr. John Eric Moore, D.O. · NPI 1063412070
Family Medicine physician in Walla Walla, Washington. Individual provider, active in the CMS NPPES registry since August 1, 2005.
## Identity
- **NPI:** 1063412070 (Entity type: Individual)
- **Enumerated:** August 1, 2005
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 01022001116 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 55 W TIETAN ST, Walla Walla, WA 99362-4498
- **Phone:** (509) 525-3720 · **Fax:** (509) 522-1593
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Cowlitz Indian Tribe (NPI 1538412630, Vancouver, WA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Nova Southeastern College Of Osteo Medicine, class of 1998
## Record status
- **NPPES last updated:** March 25, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1063412070) · Data from the CMS NPPES public registry.