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

MIRA MOORE MD
NPI 1770269763
Family Medicine in Willits, CA

Q: What is Mira Moore's NPI number?

The NPI number for Mira Moore is 1770269763. It was assigned to this individual provider in the NPPES registry on June 23, 2023.

Q: What is Mira Moore's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mira Moore was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 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.

Active since June 23, 2023PECOS Enrolled

1245 S MAIN ST, WILLITS, CA 95490(707) 459-6861(707) 459-3057 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 17, 2026, Jan 21, 2026, Jun 23, 2023 (3 updates tracked since 2023).

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About Mira Moore Md NPPES

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

MIRA MOORE MD (NPI 1770269763) is an individual family medicine provider in Willits, California, licensed in California (A206362) and active in the NPI registry since June 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1770269763

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMIRA MOORECredential: MD

Location Address1245 S MAIN STWillits, CA 95490-4305

Mailing Address1245 S Main StWillits, CA 95490-4305 · (707) 459-6861 · Fax (707) 459-3057

Phone(707) 459-6861

Fax(707) 459-3057

Sole ProprietorYes

Enumeration DateJune 23, 2023

Last NPPES UpdateSeptember 17, 20263 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2026

✔ NPI 1770269763 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A206362

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1245 S MAIN ST, Willits, CA 95490

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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 (PECOS)

Mira Moore Md 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95490 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

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

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 10

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

MISS MIRIAM IDA HARRIS M.D.

Family Medicine