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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TANISHA MOORE
NPI 1558069542
Physician Assistant in Chicago, IL

Active since February 20, 2023PECOS Enrolled
17 N STATE ST FL 5, CHICAGO, IL 60602(312) 592-6800 Get Directions Write a Review

NPPES record last updated: October 2, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 2, 2026, Jul 23, 2024, Feb 20, 2023 (3 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 Chicago, 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 Address17 N STATE ST FL 5Chicago, IL 60602-3384
Mailing Address17 N State St Fl 5Chicago, IL 60602-3384
Phone(312) 592-6800
Sole ProprietorYes
Enumeration DateFebruary 20, 2023
Last NPPES UpdateOctober 2, 20263 updates tracked since enumeration
NPPES CertifiedOctober 2, 2026
✔ 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.
17 N STATE ST FL 5, Chicago, IL 60602
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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 60602 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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LESLIE DY-ANNE MOORE-HICKS CNM
Nurse Practitioner
17 N STATE ST FL 5
CHICAGO, IL 60602
Cook County (312) 592-6800

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 17 N State St Fl 5, Chicago, IL 60602. The listed phone number is (312) 592-6800.

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 October 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.