LISA MOORE – Family Medicine Physician, NPI 1063827343

LISA MOORE is a healthcare provider. based in Glenview, Illinois. specializing in FAMILY PRACTICE. They hold a License No. A173679 (CA). The NPI Number for LISA MOORE is 1063827343

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
LISA MOORE
NPI
1063827343
Phone
(847) 657-1840
Address
2050 PFINGSTEN RD
Enumeration Date
25 June 2014
Last Update Date
18 January 2022

Doctor Profile

Medical School Name
LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Secondary Phone
3106647901
Graduation Year
2014 (12 years ago)
PAC ID
8224330105
Group Practice PAC ID
2264339126
Professional Enrollment ID
I20240202002531
Address ID
CA902305896CU4700XBLVD302
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,041 FAMILY PRACTICE in IL

Provider Addresses for LISA MOORE

  • 2050 PFINGSTEN RD

    GLENVIEW, IL 600261324

    Phone: (847) 657-1840

    Type: Location

  • 4700 INGLEWOOD BLVD

    CULVER CITY, CA 902305896

    Phone: (310) 392-8636

    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: 2024-02-02

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
I20240202002531IFamily PracticeCATBD

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 60026)

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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: 2264339126View full group profile
NameSpecialtyState
Internal Medicine, HospitalistCA
Addiction Medicine, Family PracticeCA
Clinical Social WorkerCA
Clinical Social WorkerCA
Marriage And Family TherapistCA
Family PracticeCA
Internal Medicine, Pediatric MedicineNM
P S Y C H I A T R YCA
Family PracticeCA
Family PracticeCA

Reviews

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Frequently asked questions

Does LISA MOORE share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LISA MOORE uses 1063827343.
Is LISA MOORE still practicing?
LISA MOORE is currently listed as active in the public NPI registry.
What is LISA MOORE's specialty?
The listing groups LISA MOORE with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for LISA MOORE?
LISA MOORE's geographic hint is Glenview, Illinois in our summary view.
Why does LISA MOORE have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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