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RILEY DALE MOORE
NPI 1093590838
Student in an Organized Health Care Education/Training Program in Glendale, AZ

Active since August 29, 2023PECOS Enrolled
19555 N 59TH AVE, GLENDALE, AZ 85308(623) 572-3200 Get Directions Write a Review

NPPES record last updated: August 29, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Riley Dale Moore NPPES

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

RILEY DALE MOORE (NPI 1093590838) is an individual student in an organized health care education/training program in Glendale, Arizona and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093590838
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameRILEY DALE MOORE
Location Address19555 N 59TH AVEGlendale, AZ 85308-6813
Mailing Address6125 E Indian School Rd Apt 249Scottsdale, AZ 85251-5496 · (641) 590-6259
Phone(623) 572-3200
Sole ProprietorYes
Enumeration DateAugust 29, 2023
NPPES CertifiedAugust 29, 2023
✔ NPI 1093590838 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
19555 N 59TH AVE, Glendale, AZ 85308
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Riley Dale Moore 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.

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.

ANDREW WOOD
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (310) 883-8926
ANDREA BLOCK PA-C
Physician Assistant
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200
ALIYA IMAN HABIB
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200
HUY VUONG DO
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200
SYED G MOHIUDDIN PA-C
Physician Assistant
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200
VERONICA LYNNE BUSH
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200
CHRISTOPHER LEIGH FULLMER
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (653) 572-3200
ALEXIS CATURAN
Student in an Organized Health Care Education/Training Program
19555 N 59TH AVE
GLENDALE, AZ 85308
Maricopa County (623) 572-3200

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 Riley Moore's NPI number?

The NPI number for Riley Moore is 1093590838. It was assigned to this individual provider in the NPPES registry on August 29, 2023.

Where is Riley Moore located?

Riley Moore practices at 19555 N 59th Ave, Glendale, AZ 85308. The listed phone number is (623) 572-3200.

What is Riley Moore's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Riley Moore enrolled in Medicare?

Yes. Riley Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Riley Moore was last updated on August 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.