TAYLOR KELLY MOORE
NPI 1720768534
Physician Assistant in Fort Worth, TX

Active since July 18, 2023PECOS EnrolledAccepts Medicare Assignment
1121 5TH AVE, FORT WORTH, TX 76104(817) 423-8585 Get Directions Write a Review

NPPES record last updated: May 27, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 27, 2026, Jul 18, 2023 (2 updates tracked since 2023).

About Taylor Kelly Moore NPPES

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

TAYLOR KELLY MOORE (NPI 1720768534) is an individual physician assistant in Fort Worth, Texas, licensed in Texas (16984) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1720768534
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameTAYLOR KELLY MOORE
Location Address1121 5TH AVEFort Worth, TX 76104-4383
Mailing Address1121 5th AveFort Worth, TX 76104-4383 · (817) 423-8585
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 18, 2023
Last NPPES UpdateMay 27, 20262 updates tracked since enumeration
NPPES CertifiedMay 27, 2026
NPI 1720768534 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 TX · 16984
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.

1121 5TH AVE, Fort Worth, TX 76104

Accepted Insurance

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

Taylor Kelly Moore 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 ID6305291105
PECOS Enrollment IDI20231014000138
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
384 services317 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000
An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.
63 services62 patients
Programming of dual lead pacemaker system 93280
Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.
18 services18 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
16 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$70.45 typical visit price
range $18.18 – $139.68
Typical copayment $17.61 (range $4.54 – $34.92)
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

The NPI number assigned to this healthcare provider is 1720768534, enumerated as an "individual" on July 18, 2023.

The provider is located at 1121 5TH AVE FORT WORTH, TX 76104 and the phone number is (817) 423-8585.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.