DARYL MOORE (DPT) – Physical Therapist, NPI 1124502638

DARYL MOORE (DPT) is a healthcare provider. based in Clinton twp, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 5501018902 (MI). The NPI Number for DARYL MOORE (DPT) is 1124502638

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
DARYL MOORE (DPT)
NPI
1124502638
Phone
(586) 350-2644
Address
33900 HARPER AVE STE 104
Enumeration Date
20 September 2018
Last Update Date
20 September 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2485133003
Graduation Year
2018 (8 years ago)
PAC ID
9830442391
Group Practice PAC ID
0648419077
Professional Enrollment ID
I20181030002353
Address ID
MI483741319NO46001AVEX402
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

3,481 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MI

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Provider Addresses for DARYL MOORE (DPT)

  • Harper Avenue, Saint Clair Shores, Clinton Township, Macomb County, Michigan, 48036, United States

    CLINTON TWP, MI 480354258

    Phone: (586) 350-2644

    Fax: (586) 541-3735

    Type: Mailing

  • 2020, Haggerty Road, West Bloomfield Township, Commerce Township, Oakland County, Michigan, 48390, United States

    WEST BLOOMFIELD, MI 483232189

    Phone: (248) 313-5940

    Fax: (248) 313-5941

    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: 2018-10-30

PECOS data refreshed: 2026-06-15

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
I20181030002353IPhysical Therapist In Private PracticeMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97140Therapy procedure using manual technique, each 15 minutes19514$0
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes3712$0
View full utilization report →

Insurance plans in this area (ZIP 48035)

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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: 0648419077View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeMI
Physical Therapist In Private PracticeNC

Reviews

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Frequently asked questions

How is DARYL MOORE (DPT) identified in CMS data?
CMS-hosted NPPES data lists DARYL MOORE (DPT) with NPI 1124502638.
Does the file indicate DARYL MOORE (DPT) is practicing under active NPI?
Directory data currently reports DARYL MOORE (DPT) as active.
What is DARYL MOORE (DPT)'s primary classification?
Physical Therapist is the headline specialty for DARYL MOORE (DPT) here. Clinical services aligned with this taxonomy classification.
Where should I expect DARYL MOORE (DPT) on a map?
Expect Clinton Twp, Michigan as a primary anchor for DARYL MOORE (DPT) unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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