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DR. THEODORE BRUCE MOORE M.D.
NPI 1710091020
Pediatrics - Pediatric Hematology-Oncology in Los Angeles, CA

Active since August 17, 2006PECOS Enrolled
80.5/100
CMS Quality Rating
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095(310) 825-6708(310) 206-8089 Get Directions Write a Review

NPPES record last updated: August 27, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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

NPI1710091020
Entity TypeIndividualMale
Primary Taxonomy2080P0207X
Provider Legal NameDR. THEODORE BRUCE MOORECredential: M.D.
Location Address10833 LE CONTE AVE, 12-441 MDCCLos Angeles, CA 90095-3075
Mailing Address10833 Le Conte Ave, 12-441 MdccLos Angeles, CA 90095-3075 · (310) 825-6708 · Fax (310) 206-8089
Phone(310) 825-6708
Fax(310) 206-8089
Sole ProprietorNo
Enumeration DateAugust 17, 2006
Last NPPES UpdateAugust 27, 2012
✔ NPI 1710091020 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in CA · G69308
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
10833 LE CONTE AVE, Los Angeles, CA 90095
Open in Google Maps ↗

Other Identifiers 5

Medicare UPINF81906CA
MedicaidGR0053510CA
Medicare ID-Type UnspecifiedW11810CA · Group
Medicaid00G693080CA
Medicare ID-Type UnspecifiedWG69308ACA

Medicare Participation & PECOS CMS

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

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).

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 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.

80.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.83
Promoting Interoperability100
Improvement Activities40
Cost20.85

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.

DR. JENNIFER A FULCHER M.D., PH.D.
Internal Medicine (Infectious Disease)
10833 LE CONTE AVE, CHS 37-121
LOS ANGELES, CA 90095
Los Angeles County (310) 825-7225
LEE HAROLD HILBORNE MD
Pathology (Anatomic Pathology & Clinical Pathology)
10833 LE CONTE AVE, STE B-186 CHS
LOS ANGELES, CA 90095
Los Angeles County (310) 794-8285
PETER TONTONOZ MD
Pathology (Anatomic Pathology)
10833 LE CONTE AVE, STE B-186 CHS
LOS ANGELES, CA 90095
Los Angeles County (310) 794-8285
HSIN Y LEE MD
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-4721
COLIN J. WELLS MD
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 301-6800
RODNEY L TEICHNER MD
Anesthesiology
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-9111
DR. LLOYD EDWARD GREASER III M.D.
Radiology (Diagnostic Radiology)
10833 LE CONTE AVE, DEPARTMENT OF RADIOLOGY
LOS ANGELES, CA 90095
Los Angeles County (310) 825-4321
BRANDON KEN ITAGAKI M.D.
Internal Medicine
10833 LE CONTE AVE
LOS ANGELES, CA 90095
Los Angeles County (310) 825-8307

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.

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 13 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.