ROGER L. MOORE (PA) – Physician Assistant, NPI 1295793099
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,797 PHYSICIAN ASSISTANT in OK
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Provider Addresses for ROGER L. MOORE (PA)
PO BOX 22063
DEPT 0289
TULSA, OK 741212063
Phone: (405) 751-4664
Fax: (405) 749-4561
Type: Mailing
South Garnett Road, Tulsa, Tulsa County, Oklahoma, 74146, United States
C/O MEDCENTER
TULSA, OK 741295101
Phone: (918) 665-1520
Fax: (405) 749-4561
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2024-10-01 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-01
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $13 |
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: 2005-03-07
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050307000462 | I | Physician Assistant | OK | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 106 | 102 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 105 | 100 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 73 | 70 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 66 | 65 | $0 |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 38 | 19 | $0 |
Insurance plans in this area (ZIP 74121)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OK | |
| Nurse Practitioner | KS | |
| Nurse Practitioner | OK | |
| Nurse Practitioner | KS | |
| Physician Assistant | OK | |
| Family Practice | OK | |
| - | OK | |
| - | OK | |
| Emergency Medicine | OK | |
| Nurse Practitioner | OK |
Reviews
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