BRECKEN DEWEY MOORE (FNP) – Nurse Practitioner, NPI 1336830108

BRECKEN DEWEY MOORE (FNP) is a healthcare provider. based in Midvale, Utah. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 120502688900 (UT). The NPI Number for BRECKEN DEWEY MOORE (FNP) is 1336830108

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
BRECKEN DEWEY MOORE (FNP)
NPI
1336830108
Phone
(435) 590-2312
Address
1004 W TUSCANY VIEW RD UNIT 1705
Enumeration Date
15 May 2023
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4357039647
Graduation Year
2023 (3 years ago)
PAC ID
8325489016
Group Practice PAC ID
1254766371
Professional Enrollment ID
I20240513001658
Address ID
UT847707329ST1664XDRXX403
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

2,655 NURSE PRACTITIONER in UT

Provider Addresses for BRECKEN DEWEY MOORE (FNP)

  • 1004 W TUSCANY VIEW RD UNIT 1705

    MIDVALE, UT 840474826

    Phone: (435) 590-2312

    Type: Mailing

  • 7410 S CREEK RD STE 100

    SANDY, UT 840936151

    Phone: (801) 816-1010

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 146 Open Payments records for all available years, with a total value of $2,996.

Total Amount is formed as General ($2,996) + Research ($0) + Ownership ($0) = $2,996.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Lilly USA, LLC ($476).

Total Amount

$2,996

General + Research + Ownership

Payments

146

Total payment records

General Amount

$2,996

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2024-05-13

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
I20240513001658INurse PractitionerUTTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84047)

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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: 1254766371View full group profile
NameSpecialtyState
Mental Health CounselorUT
Nurse PractitionerUT
Nurse PractitionerUT
Clinical Social WorkerUT
Clinical Social WorkerUT
Nurse PractitionerUT

Reviews

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Frequently asked questions

Can I verify BRECKEN DEWEY MOORE (FNP) with an NPI only?
You can start verification with NPI 1336830108 for BRECKEN DEWEY MOORE (FNP), then check state licensing separately.
Is BRECKEN DEWEY MOORE (FNP) listed as active for patients and plans?
The listing shows BRECKEN DEWEY MOORE (FNP) as active in the NPI system.
What healthcare role does BRECKEN DEWEY MOORE (FNP) hold?
Scheduling teams often label BRECKEN DEWEY MOORE (FNP) under Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Does BRECKEN DEWEY MOORE (FNP) list a practice location?
Patients near Midvale, Utah may find BRECKEN DEWEY MOORE (FNP) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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