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SIDNEY CELINE MOORE PHYSICIAN ASSISTANT
NPI 1194699199
Physician Assistant in Port Orange, FL

Active since October 02, 2025PECOS Enrolled
1728 DUNLAWTON AVE STE 5, PORT ORANGE, FL 32127(386) 304-3404 Get Directions Write a Review

NPPES record last updated: March 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Sidney Celine Moore Physician Assistant NPPES

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

SIDNEY CELINE MOORE PHYSICIAN ASSISTANT (NPI 1194699199) is an individual physician assistant in Port Orange, Florida and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1194699199
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSIDNEY CELINE MOORECredential: PHYSICIAN ASSISTANT
Location Address1728 DUNLAWTON AVE STE 5Port Orange, FL 32127-2923
Mailing Address4850 Millenia BlvdOrlando, FL 32839-6012
Phone(386) 304-3404
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 2, 2025
Last NPPES UpdateMarch 28, 2026
NPPES CertifiedMarch 28, 2026
✔ NPI 1194699199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
1728 DUNLAWTON AVE STE 5, Port Orange, FL 32127
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Secondary Practice Locations 2

Location 1325 Clyde Morris Blvd Ste 300Ormond Beach, FL 32174-8179 · Phone (386) 304-3404
Location 2385 Palm Coast Pkwy SW Unit 2Palm Coast, FL 32137-4784 · Phone (386) 304-1811

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sidney Celine Moore Physician Assistant is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224509971
PECOS Enrollment IDI20260603004763
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 32127 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
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.

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 Sidney Moore's NPI number?

The NPI number for Sidney Moore is 1194699199. It was assigned to this individual provider in the NPPES registry on October 2, 2025.

Where is Sidney Moore located?

Sidney Moore practices at 1728 Dunlawton Ave Ste 5, Port Orange, FL 32127. The listed phone number is (386) 304-3404.

What is Sidney Moore's specialty?

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

Is Sidney Moore enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Sidney Moore was last updated on March 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.