S.JASON MOORE (P.A.) – Surgical Physician Assistant, NPI 1356468979

S.JASON MOORE (P.A.) is a healthcare provider. based in Louisville, Colorado. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 2029 (CO). The NPI Number for S.JASON MOORE (P.A.) is 1356468979

Main info

Male
22 Years Of Experience
Accepts Medicare Assignment
Name
S.JASON MOORE (P.A.)
NPI
1356468979
Phone
(970) 569-7478
Address
PO BOX 270596
Enumeration Date
26 March 2007
Last Update Date
22 December 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4066324351
Graduation Year
2004 (22 years ago)
PAC ID
2163523325
Group Practice PAC ID
3375451370
Professional Enrollment ID
I20210824002313
Address ID
MT590360000HA25XXXNXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,161 PHYSICIAN ASSISTANT in CO

Provider Addresses for S.JASON MOORE (P.A.)

  • PO BOX 270596

    LOUISVILLE, CO 800275009

    Phone: (970) 569-7478

    Fax: (970) 569-7453

    Type: Mailing

  • 181 W MEADOW DR

    VAIL, CO 816575242

    Phone: (970) 479-5036

    Fax: (970) 569-7453

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-08-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210824002313IPhysician AssistantMTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80027)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375451370View full group profile
NameSpecialtyState
Emergency Medicine, Allergy/ImmunologyMT
Nurse PractitionerMT
Nurse PractitionerMT
Physician AssistantMP
Nurse PractitionerFL
Family PracticeWV
Nurse PractitionerAZ
Diagnostic RadiologyMN
Nurse PractitionerMT

Reviews

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Frequently asked questions

What is the standard ID for S.JASON MOORE (P.A.) in the U.S.?
In the U.S., S.JASON MOORE (P.A.) is identified by NPI 1356468979.
Is S.JASON MOORE (P.A.)'s NPI status active today?
Active status means S.JASON MOORE (P.A.)'s NPI record is not deactivated in the public file.
Which specialty label fits S.JASON MOORE (P.A.)?
NPPES ties S.JASON MOORE (P.A.) to Surgical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit S.JASON MOORE (P.A.) in Louisville, Colorado?
For routing, start with Louisville, Colorado for S.JASON MOORE (P.A.), then verify phone and hours locally.
Why is information missing for S.JASON MOORE (P.A.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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