DR. THEODORE BRUCE MOORE M.D.
NPI 1710091020
Pediatrics - Pediatric Hematology-Oncology in Los Angeles, CA
About Dr. Theodore Bruce Moore M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. THEODORE BRUCE MOORE M.D. (NPI 1710091020) is an individual pediatric hematology-oncology provider in Los Angeles, California, licensed in California (G69308) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Theodore Bruce Moore M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Theodore Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90095
- Reassigned Medicare billing, California enrollment
- 323 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
LOS ANGELES, CA 90095
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 Theodore Moore's NPI number?
The NPI number for Theodore Moore is 1710091020. It was assigned to this individual provider in the NPPES registry on August 17, 2006.
Where is Theodore Moore located?
Theodore Moore practices at 10833 Le Conte Ave 12-441 Mdcc, Los Angeles, CA 90095. The listed phone number is (310) 825-6708.
What is Theodore Moore's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.
Is Theodore Moore enrolled in Medicare?
Yes. Theodore Moore is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Theodore Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Moore reassigns Medicare benefits to Uc Regents (Los Angeles, CA). The 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 Theodore Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Theodore Moore was last updated on August 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Dr. Theodore Bruce Moore, M.D. · NPI 1710091020
Pediatric Hematology-Oncology physician in Los Angeles, California. Individual provider, active in the CMS NPPES registry since August 17, 2006.
## Identity
- **NPI:** 1710091020 (Entity type: Individual)
- **Enumerated:** August 17, 2006
- **Primary specialty:** Pediatrics - Pediatric Hematology-Oncology · taxonomy 2080P0207X
- **State license:** G69308 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 10833 LE CONTE AVE, 12-441 MDCC, Los Angeles, CA 90095-3075
- **Phone:** (310) 825-6708 · **Fax:** (310) 206-8089
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Uc Regents (NPI 1982667663, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 27, 2012
- **Other identifiers:** Medicare UPIN F81906 (CA); Medicaid GR0053510 (CA); Medicare ID-Type Unspecified W11810 (CA); and 2 more
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Source: [NPI Profile](https://npiprofile.com/npi/1710091020) · Data from the CMS NPPES public registry.