JEFFREY MOORE (RN) – General Practice Registered Nurse, NPI 1205415205

JEFFREY MOORE (RN) is a healthcare provider. based in Pahrump, Nevada. specializing in NURSE PRACTITIONER. They hold the professional credentials RN. They hold a License No. RN96780 (NV). The NPI Number for JEFFREY MOORE (RN) is 1205415205

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY MOORE (RN)
NPI
1205415205
Phone
Not provided
Address
1470 E CALVADA BLVD STE 100
Enumeration Date
6 April 2021
Last Update Date
6 April 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9549395000
Graduation Year
2022 (4 years ago)
PAC ID
7810367430
Group Practice PAC ID
2062635378
Professional Enrollment ID
I20221222002379
Address ID
NV890480884PA360XXLNXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

2,947 NURSE PRACTITIONER in NV

Provider Addresses for JEFFREY MOORE (RN)

  • 1470 E CALVADA BLVD STE 100

    PAHRUMP, NV 890483906

    Phone:

    Type: Mailing

  • 1470 E CALVADA BLVD

    PAHRUMP, NV 890483905

    Phone: (775) 210-8333

    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: 2022-12-22

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
I20221222002379INurse PractitionerNVTBD

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
99285Emergency department visit with high level of medical decision making184178$0
99284Emergency department visit with moderate level of medical decision making6161$0
99291Critical care, first 30-74 minutes2020$0
99283Emergency department visit with low level of medical decision making1212$0
View full utilization report →

Insurance plans in this area (ZIP 89048)

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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: 2062635378View full group profile
NameSpecialtyState
Physician AssistantME
Nurse PractitionerOH
Nurse PractitionerNV

Reviews

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Frequently asked questions

How is JEFFREY MOORE (RN) identified in CMS data?
CMS-hosted NPPES data lists JEFFREY MOORE (RN) with NPI 1205415205.
Does the file indicate JEFFREY MOORE (RN) is practicing under active NPI?
Directory data currently reports JEFFREY MOORE (RN) as active.
What is JEFFREY MOORE (RN)'s specialty?
The listing groups JEFFREY MOORE (RN) with General Practice Registered Nurse. Clinical services aligned with this taxonomy classification.
What address line appears for JEFFREY MOORE (RN)?
JEFFREY MOORE (RN)'s geographic hint is Pahrump, Nevada in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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