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JULIA MOORE PA
NPI 1790501773
Physician Assistant in Grand Rapids, MI

Active since November 25, 2024Opted out of Medicare · through Feb 9, 2028
3272 PLATINUM NE, GRAND RAPIDS, MI 49525(616) 226-2669 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Julia Moore Pa NPPES

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

JULIA MOORE PA (NPI 1790501773) is an individual physician assistant in Grand Rapids, Michigan and active in the NPI registry since November 2024. She has opted out of Medicare through February 9, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1790501773
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameJULIA MOORECredential: PA
Location Address3272 PLATINUM NEGrand Rapids, MI 49525
Mailing Address1 Campus DrAllendale, MI 49401-9401
Phone(616) 226-2669
Sole ProprietorNo
Enumeration DateNovember 25, 2024
Last NPPES UpdateJanuary 5, 2026
NPPES CertifiedJanuary 5, 2026
✔ NPI 1790501773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
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.
3272 PLATINUM NE, Grand Rapids, MI 49525
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Julia Moore Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 9, 2026 through February 9, 2028.

Opt-Out Effective DateFebruary 9, 2026
Opt-Out In Effect ThroughFebruary 9, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49525 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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 NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Julia Moore's NPI number?

The NPI number for Julia Moore is 1790501773. It was assigned to this individual provider in the NPPES registry on November 25, 2024.

Where is Julia Moore located?

Julia Moore practices at 3272 Platinum NE, Grand Rapids, MI 49525. The listed phone number is (616) 226-2669.

What is Julia Moore's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Julia Moore enrolled in Medicare?

No. Julia Moore has opted out of Medicare through February 9, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Julia Moore was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.