TRACY MOORE (APRN-PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063232494

TRACY MOORE (APRN-PMHNP) is a healthcare provider. based in Homestead, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN-PMHNP. They hold a License No. 11035774 (FL). The NPI Number for TRACY MOORE (APRN-PMHNP) is 1063232494

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
TRACY MOORE (APRN-PMHNP)
NPI
1063232494
Phone
(305) 281-6566
Address
20461 SW 317TH ST
Enumeration Date
11 October 2024
Last Update Date
11 October 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9702352625
Graduation Year
2024 (2 years ago)
PAC ID
5193216257
Group Practice PAC ID
5991217481
Professional Enrollment ID
I20251117001871
Address ID
CO815018808GR2525XSTXX415
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for TRACY MOORE (APRN-PMHNP)

  • 20461 SW 317TH ST

    HOMESTEAD, FL 330307727

    Phone: (305) 281-6566

    Mailing address matches the actual address.

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: 2025-11-17

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
I20251117001871INurse PractitionerCOTBD

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 33030)

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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: 5991217481View full group profile
NameSpecialtyState
Physician AssistantCO
P S Y C H I A T R YCO
Nurse PractitionerMS
Physician AssistantCO
Nurse PractitionerTX

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Frequently asked questions

How do I look up TRACY MOORE (APRN-PMHNP) by NPI?
Use NPI 1063232494 when you need to reference TRACY MOORE (APRN-PMHNP) in forms, claims, or directories.
Is TRACY MOORE (APRN-PMHNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does TRACY MOORE (APRN-PMHNP) work in?
You can think of TRACY MOORE (APRN-PMHNP) as practicing within Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is TRACY MOORE (APRN-PMHNP)'s primary listing?
We display Homestead, Florida because that is what the record indicates for TRACY MOORE (APRN-PMHNP).
Is TRACY MOORE (APRN-PMHNP) a real provider?
This page reflects official NPPES data for NPI 1063232494. Always confirm identity and privileges with the practice and licensing boards.

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