CASSANDRA MOORE (CNP) – Nurse Practitioner, NPI 1679709117

CASSANDRA MOORE (CNP) is a healthcare provider. based in Cumberland, Wisconsin. specializing in Nurse Practitioner. They hold the professional credentials CNP. They hold a License No. 89488 (WI). The NPI Number for CASSANDRA MOORE (CNP) is 1679709117

Main info

Female
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
CASSANDRA MOORE (CNP)
NPI
1679709117
Phone
(715) 822-7222
Address
1110 7TH AVE
Enumeration Date
10 June 2009
Last Update Date
6 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7157190662
Graduation Year
2000 (26 years ago)
PAC ID
3476518556
Group Practice PAC ID
8729072418
Professional Enrollment ID
I20041130001107
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

Provider Addresses for CASSANDRA MOORE (CNP)

  • 1110 7TH AVE

    CUMBERLAND, WI 548299138

    Phone: (715) 822-7222

    Type: Location

  • West Avenue, Dundas, Rice County, Minnesota, 55019, United States

    RICE LAKE, WI 548684425

    Phone: (715) 822-2231

    Type: Mailing

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: 2004-11-30

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
I20041130001107INurse PractitionerWITBD

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 54829)

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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: 8729072418View full group profile

Reviews

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Frequently asked questions

How is CASSANDRA MOORE (CNP) identified in CMS data?
CMS-hosted NPPES data lists CASSANDRA MOORE (CNP) with NPI 1679709117.
Is CASSANDRA MOORE (CNP) listed as active for patients and plans?
The listing shows CASSANDRA MOORE (CNP) as active in the NPI system.
What is CASSANDRA MOORE (CNP)'s specialty?
The listing groups CASSANDRA MOORE (CNP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is CASSANDRA MOORE (CNP) based?
CASSANDRA MOORE (CNP) is tied to Cumberland, Wisconsin in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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