WYLIE MASTERSON MOODY MD
NPI 1740920529
Dermatology in Victoria, TX
About Wylie Masterson Moody Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WYLIE MASTERSON MOODY MD (NPI 1740920529) is an individual dermatology provider in Victoria, Texas, licensed in Texas (V8697) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS and is a graduate of University Of Texas Medical School At Houston (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Wylie Masterson Moody Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Wylie Moody reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Victoria, TX 77904
- Reassigned Medicare billing, Texas enrollment
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 77904 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Wylie Moody's NPI number?
The NPI number for Wylie Moody is 1740920529. It was assigned to this individual provider in the NPPES registry on March 30, 2022.
Where is Wylie Moody located?
Wylie Moody practices at 6404 Nursery Dr Ste 201, Victoria, TX 77904. The listed phone number is (361) 724-3864.
What is Wylie Moody's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Wylie Moody enrolled in Medicare?
Yes. Wylie Moody is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Wylie Moody's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Wylie Moody reassigns Medicare benefits to Wylie Moody, MD (Victoria, TX). 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 Wylie Moody's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Wylie Moody accept?
Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Wylie Moody as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Wylie Moody was last updated on August 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.
# Wylie Masterson Moody, MD · NPI 1740920529
Dermatology physician in Victoria, Texas. Individual provider, active in the CMS NPPES registry since March 30, 2022.
## Identity
- **NPI:** 1740920529 (Entity type: Individual)
- **Enumerated:** March 30, 2022
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **State license:** V8697 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 6404 NURSERY DR STE 201, Victoria, TX 77904-1688
- **Phone:** (361) 724-3864 · **Fax:** (361) 288-3075
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Wylie Moody, MD (NPI 1184582215, Victoria, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Medical School At Houston, class of 2022
## Record status
- **NPPES last updated:** August 12, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1740920529) · Data from the CMS NPPES public registry.