MADELINE MOORE (PAC) – Physician Assistant, NPI 1225567399

MADELINE MOORE (PAC) is a healthcare provider. based in Grapevine, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PAC. They hold a License No. PA11335 (TX). The NPI Number for MADELINE MOORE (PAC) is 1225567399

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
MADELINE MOORE (PAC)
NPI
1225567399
Phone
(817) 481-2121
Address
2535 IRA E WOODS AVE
Enumeration Date
12 June 2017
Last Update Date
27 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8174812121
Graduation Year
2017 (9 years ago)
PAC ID
7517237779
Group Practice PAC ID
2769448430
Professional Enrollment ID
I20170720000655
Address ID
TX762448941FO4501XPKWY422
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for MADELINE MOORE (PAC)

  • 2535, Ira E Woods Avenue, Grapevine, Tarrant County, Texas, 76051, United States

    GRAPEVINE, TX 760513930

    Phone: (817) 481-2121

    Fax: (817) 488-4493

    Type: Mailing

  • 4501 Heritage Trace Pkwy Ste 101

    Fort Worth, TX 762448940

    Phone: (817) 481-2121

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $133.

Total Amount is formed as General ($133) + Research ($0) + Ownership ($0) = $133.

Last reported payment date: 2024-06-04 • Largest payer in this snapshot: ABIOMED ($108).

Total Amount

$133

General + Research + Ownership

Payments

2

Total payment records

General Amount

$133

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-06-04

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABIOMED$108
Novo Nordisk Inc$25
View all Open Payments →|Open Payments Risk Radar →

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: 2017-07-20

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
I20170720000655IPhysician AssistantTXTBD

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
73630X-ray of foot, minimum of 3 views5236$0
99213Established patient office or other outpatient visit, 20-29 minutes4136$0
73610X-ray of ankle, minimum of 3 views2517$0
27447Replacement of knee joint, both sides of knee1514$0
View full utilization report →

Insurance plans in this area (ZIP 76051)

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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: 2769448430View full group profile
NameSpecialtyState
Physician AssistantTX
Physician AssistantTX
Physician AssistantTX
Orthopedic SurgeryTX
Physician AssistantTX
-TX
Physician AssistantTX
-TX
Orthopedic SurgeryTX
Physician AssistantTX

Reviews

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Frequently asked questions

Can I verify MADELINE MOORE (PAC) with an NPI only?
You can start verification with NPI 1225567399 for MADELINE MOORE (PAC), then check state licensing separately.
Does CMS list MADELINE MOORE (PAC) as active?
Yes — MADELINE MOORE (PAC) is active in the NPI listing used on this page.
What taxonomy line describes MADELINE MOORE (PAC)?
For research purposes, treat MADELINE MOORE (PAC) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
What area does MADELINE MOORE (PAC) serve?
MADELINE MOORE (PAC)'s listing highlights Grapevine, Texas; more addresses can appear in NPPES.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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