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

WILESHA SHANISE MOORE PA-C
NPI 1659136240
Physician Assistant in Greenville, SC

Q: What is Wilesha Moore's NPI number?

The NPI number for Wilesha Moore is 1659136240. It was assigned to this individual provider in the NPPES registry on February 14, 2024.

Q: What is Wilesha Moore's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Wilesha Moore was last updated on July 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

Active since February 14, 2024PECOS Enrolled

545 W BUTLER RD, GREENVILLE, SC 29607(864) 299-1990(864) 299-9123 Get Directions Write a Review

NPPES record last updated: July 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 25, 2026, Apr 16, 2026 (2 updates tracked since 2026).

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About Wilesha Shanise Moore Pa-c NPPES

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

WILESHA SHANISE MOORE PA-C (NPI 1659136240) is an individual physician assistant in Greenville, South Carolina, licensed in South Carolina (6106) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Greenville, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1659136240

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameWILESHA SHANISE MOORECredential: PA-C

Location Address545 W BUTLER RDGreenville, SC 29607-4833

Mailing Address545 W Butler RdGreenville, SC 29607-4833 · (864) 299-1990 · Fax (864) 299-9123

Phone(864) 299-1990

Fax(864) 299-9123

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateFebruary 14, 2024

Last NPPES UpdateJuly 25, 20262 updates tracked since enumeration

NPPES CertifiedJuly 25, 2026

✔ NPI 1659136240 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 SC · 6106

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.

545 W BUTLER RD, Greenville, SC 29607

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Secondary Practice Location 1

Location 12555 N Pleasantburg DrGreenville, SC 29609-3030 · Phone (864) 609-4008 · Fax (864) 299-9123

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Wilesha Shanise Moore Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688146608

PECOS Enrollment IDI20260610003677

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 29607 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

$83.18 typical visit price

range $53.57 – $163.84

Typical copayment $20.79 (range $13.39 – $40.96)

Most-billed visit code 99203

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

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 10

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

NGAN KIM MORAN DNP, FNP

Nurse Practitioner (Family)