SAMUEL MOON
NPI 1336851609
Optometrist in Granbury, TX
About Samuel Moon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SAMUEL MOON (NPI 1336851609) is a healthcare organization registered as an optometrist in Granbury, Texas and active in the NPI registry since December 2022. The organization lists Samuel Moon, Owner/ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Samuel Moon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Samuel Moon, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Samuel Moon's NPI number?
The NPI number for Samuel Moon is 1336851609. It was assigned to this organization in the NPPES registry on December 19, 2022.
Where is Samuel Moon located?
Samuel Moon is located at 735 E Us Highway 377, Granbury, TX 76048. The listed phone number is (254) 485-4088.
What is Samuel Moon's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Samuel Moon enrolled in Medicare?
Yes. Samuel Moon is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Samuel Moon?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Samuel Moon. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Samuel Moon accept?
Health plans from BlueCross BlueShield of Tennessee list Samuel Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Samuel Moon was last updated on December 19, 2022. 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.
# Samuel Moon · NPI 1336851609
Optometrist organization in Granbury, Texas. Organization record, active in the CMS NPPES registry since December 19, 2022.
## Identity
- **NPI:** 1336851609 (Entity type: Organization)
- **Enumerated:** December 19, 2022
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Samuel Moon, OWNER/CEO
## Practice location
- **Address:** 735 E US HIGHWAY 377, Granbury, TX 76048-2578
- **Phone:** (254) 485-4088
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Optometry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 19, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1336851609) · Data from the CMS NPPES public registry.