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TANISHA MOORE
NPI 1558069542
Physician Assistant in Wilmette, IL

Active since February 20, 2023PECOS Enrolled
311A RIDGE RD APT 113, WILMETTE, IL 60091(267) 505-6106 Get Directions Write a Review

NPPES record last updated: July 23, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 23, 2024, Feb 20, 2023 (2 updates tracked since 2023).

About Tanisha Moore NPPES

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

TANISHA MOORE (NPI 1558069542) is an individual physician assistant in Wilmette, Illinois, licensed in Illinois (085-009934) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558069542
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTANISHA MOORE
Location Address311A RIDGE RD APT 113Wilmette, IL 60091-3256
Mailing Address311a Ridge Rd Apt 113Wilmette, IL 60091-3256 · (267) 505-6106
Phone(267) 505-6106
Sole ProprietorYes
Enumeration DateFebruary 20, 2023
Last NPPES UpdateJuly 23, 20242 updates tracked since enumeration
NPPES CertifiedJuly 23, 2024
✔ NPI 1558069542 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IL · 085-009934
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.
311A RIDGE RD APT 113, Wilmette, IL 60091
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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)

Tanisha 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60091 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
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 Tanisha Moore's NPI number?

The NPI number for Tanisha Moore is 1558069542. It was assigned to this individual provider in the NPPES registry on February 20, 2023.

Where is Tanisha Moore located?

Tanisha Moore practices at 311A Ridge Rd Apt 113, Wilmette, IL 60091. The listed phone number is (267) 505-6106.

What is Tanisha Moore's specialty?

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

Is Tanisha Moore enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Tanisha Moore was last updated on July 23, 2024. 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.