Doctor profile · Federal record
Dr. Shane Moore, DO
Surgery Physician (CMS: General Surgery) · Student in an Organized Health Care Education/Training Program · Prescott Valley, AZ
- NPI 1982224796
- Accepts Medicare
- 6 yrs in practice
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 3 locations .
- Primary practice
-
7700 E Florentine RD Ste 203
Prescott Valley, AZ 863142245
(928) 708-4310
fax (928) 548-2164 - Additional location
-
1001 Willow Creek RD Ste 1200
Prescott, AZ 863011614
(928) 458-2995
fax (928) 458-2139 - Additional location
-
1301 S Crismon RD
Mesa, AZ 852093767
(480) 358-6450 - Mailing address
-
Po Box 10880
Prescott, AZ 863040880
Credentials & registration
- NPI registered
- April 2020 — 6 yrs on file
- Profile last updated
- June 3, 2025
- Year of graduation
- 2020 — 6 yrs since
- Specialty taxonomy
- 208600000X — NUCC code
- State license (1)
- Arizona #011620
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1982224796. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$116
Transactions
4
Manufacturers
3
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| AngioDynamics, INC. | 1 | $56.40 | |
| Urgo Medical North America, LLC | 2 | $37.31 | |
| Takeda Pharmaceuticals U.S.A., INC. | 1 | $22.07 |
By nature of payment
Frequently asked questions
What is Dr. Shane Moore's medical specialty?
Dr. Shane Moore practices Surgery Physician in Prescott Valley, AZ.
Where does Dr. Shane Moore practice?
Dr. Shane Moore practices at 7700 E Florentine RD Ste 203, Prescott Valley, AZ 863142245. Office phone: 9287084310.
What is Dr. Shane Moore's NPI?
Dr. Shane Moore's National Provider Identifier (NPI) is 1982224796, issued by NPPES.
Does Dr. Shane Moore accept Medicare assignment?
Yes. Dr. Shane Moore accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.