SHANE MOORE
NPI 1417426529
Nurse Practitioner - Family in Waco, TX

Q: What is Shane Moore's NPI number?

The NPI number for Shane Moore is 1417426529. It was assigned to this individual provider in the NPPES registry on November 19, 2018.

Q: What is Shane Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Moore was last updated on October 14, 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.

Active since November 19, 2018PECOS Enrolled

7030 NEW SANGER AVE STE 204, WACO, TX 76712(254) 245-9175(254) 213-7771 Get Directions Write a Review

NPPES record last updated: October 14, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 14, 2020, Nov 19, 2018 (2 updates tracked since 2018).

On this page

About Shane Moore NPPES

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

SHANE MOORE (NPI 1417426529) is an individual family provider in Waco, Texas, licensed in Texas (AP139172) and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Waco, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1417426529

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameSHANE MOORE

Location Address7030 NEW SANGER AVE STE 204Waco, TX 76712-4074

Mailing AddressPo Box 11538Killeen, TX 76547-1538 · (254) 245-9177 · Fax (254) 245-9178

Phone(254) 245-9175

Fax(254) 213-7771

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateNovember 19, 2018

Last NPPES UpdateOctober 14, 20202 updates tracked since enumeration

NPPES CertifiedOctober 14, 2020

✔ NPI 1417426529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in TX · AP139172

7030 NEW SANGER AVE STE 204, Waco, TX 76712

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Secondary Practice Location 1

Location 12304 Marketplace DrWaco, TX 76711-2467 · Phone (254) 202-7300 · Fax (254) 202-7350

Other Identifiers 1

OtherAP139172TX · License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane Moore is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7618211285

PECOS Enrollment IDI20181208000051

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

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

Premier Physicians-Ii, P.A.

1.7 mi

Urgent Care

9110 JORDAN LN STE 100
Woodway, TX 76712

Reassigned Medicare billing, Texas enrollment
Medicare enrollment name: Premier Physicians - Ii PA
92 clinicians in this Medicare group

NPI 1801204656 (254) 855-6318

Healthnow Urgent Care Inc

31 mi

Urgent Care

200 N SAN JACINTO ST
Whitney, TX 76692

Reassigned Medicare billing, Texas enrollment
11 clinicians in this Medicare group

NPI 1447779152 (214) 718-5284

Legacy Urgent Care, PA

115 mi

Urgent Care

9205 LEGACY DR
Frisco, TX 75033

Reassigned Medicare billing, Texas enrollment
279 clinicians in this Medicare group

NPI 1568622272 (972) 668-6020

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

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

77 services74 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

60 services30 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

50 services50 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

32 services31 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

27 services26 patients

Blood test, comprehensive group of blood chemicals 80053

A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.

26 services25 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76712 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

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

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 Shane Moore's NPI number?

The NPI number for Shane Moore is 1417426529. It was assigned to this individual provider in the NPPES registry on November 19, 2018.

Where is Shane Moore located?

Shane Moore practices at 7030 New Sanger Ave Ste 204, Waco, TX 76712. The listed phone number is (254) 245-9175.

What is Shane Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Shane Moore enrolled in Medicare?

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

Which organizations bill Medicare for Shane Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shane Moore reassigns Medicare benefits to 3 organizations: Premier Physicians-Ii, P.A. (Woodway, TX), Healthnow Urgent Care Inc (Whitney, TX) and Legacy Urgent Care, PA (Frisco, TX). 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 Shane Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shane Moore accept?

Health plans from Blue Cross and Blue Shield of Texas list Shane Moore 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 Shane Moore was last updated on October 14, 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.