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

WYLIE MASTERSON MOODY MD
NPI 1740920529
Dermatology in Victoria, TX

Active since March 30, 2022PECOS EnrolledAccepts Medicare Assignment
6404 NURSERY DR STE 201, VICTORIA, TX 77904(361) 724-3864(361) 288-3075 Get Directions Write a Review

NPPES record last updated: August 12, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Aug 12, 2026, Mar 12, 2026 (2 updates tracked since 2026).

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

NPI1740920529
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameWYLIE MASTERSON MOODYCredential: MD
Location Address6404 NURSERY DR STE 201Victoria, TX 77904-1688
Mailing Address6404 Nursery Dr Ste 201Victoria, TX 77904-1688 · (361) 724-3864 · Fax (361) 288-3075
Phone(361) 724-3864
Fax(361) 288-3075
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 2022
Enumeration DateMarch 30, 2022
Last NPPES UpdateAugust 12, 20262 updates tracked since enumeration
NPPES CertifiedAugust 12, 2026
✔ NPI 1740920529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in TX · V8697
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
6404 NURSERY DR STE 201, Victoria, TX 77904
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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

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.

PECOS PAC ID2668859968
PECOS Enrollment IDI20260520003980
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 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.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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

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

WYLIE MOODY, MD
Dermatology
6404 NURSERY DR STE 201
VICTORIA, TX 77904
Victoria County (832) 330-9162

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.

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 19 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.