MRS. MARY MELISSA MOORE (P.T.) – Physical Therapist, NPI 1639326184

MRS. MARY MELISSA MOORE (P.T.) is a healthcare provider. based in Berrien springs, Michigan. specializing in Physical Therapist. They hold the professional credentials P.T.. They hold a License No. 5501010163 (MI). The NPI Number for MRS. MARY MELISSA MOORE (P.T.) is 1639326184

Main info

Female
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARY MELISSA MOORE (P.T.)
NPI
1639326184
Phone
(269) 684-7130
Address
11031 JONES RD
Enumeration Date
26 August 2008
Last Update Date
26 August 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2696846870
Graduation Year
1999 (27 years ago)
PAC ID
7214005891
Group Practice PAC ID
3375500093
Professional Enrollment ID
I20081009000215
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

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Provider Addresses for MRS. MARY MELISSA MOORE (P.T.)

  • 11031 JONES RD

    BERRIEN SPRINGS, MI 491039660

    Phone: (269) 684-7130

    Type: Mailing

  • 2500, Niles Road, Vineland, Saint Joseph Charter Township, Berrien County, Michigan, 49085, United States

    SUITE 3

    SAINT JOSEPH, MI 490853237

    Phone: (269) 428-1550

    Fax: (269) 428-6762

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 49103)

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Provider's Procedures

MRS. MARY MELISSA MOORE (P.T.) performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMI97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes24325

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: 3375500093View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIN
-IN
Interventional Pain Management, Physical Medicine And Rehabilitation, Physical Medicine And RehabilitationIN
-MI
-IN
-IN
-MI

Reviews

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Frequently asked questions

Where can patients find MRS. MARY MELISSA MOORE (P.T.)'s NPI?
You can confirm MRS. MARY MELISSA MOORE (P.T.) with NPI 1639326184; it appears in the national provider directory.
Is MRS. MARY MELISSA MOORE (P.T.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does MRS. MARY MELISSA MOORE (P.T.) treat or focus on?
Patients typically see MRS. MARY MELISSA MOORE (P.T.) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
What location metadata exists for MRS. MARY MELISSA MOORE (P.T.)?
The page summarizes Berrien Springs, Michigan for MRS. MARY MELISSA MOORE (P.T.); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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