Traci Moore, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Kingman, Arizona. She went to University Of Arizona College Of Medicine - Phoenix and graduated in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Bhsm Rehabilitation Llc, Lakeside Heart And Vascular Center Pllc and her current practice location is
3931 N Stockton Hill Rd, Kingman, Arizona. You can reach out to her office (for appointments etc.) via phone at
(928) 385-7100.
Traci Moore is licensed to practice in Arizona (license number 315038) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1225570005.
Physician's Profile
| Full Name | Traci Moore |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner |
|---|
| Experience | 5 Years |
|---|
| Location | 3931 N Stockton Hill Rd, Kingman, Arizona |
|---|
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Traci Moore attended and graduated from University Of Arizona College Of Medicine - Phoenix in 2020
NPI Data:
- NPI Number: 1225570005
- Provider Enumeration Date: 11/10/2016
- Last Update Date: 12/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 3476085457
- Enrollment ID: I20241015003254
Medical Identifiers
Medical identifiers for Traci Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225570005 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | RNP315038 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 315038 (Arizona) | Primary |
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | RN186954 (Arizona) | Secondary |
| 163W00000X | Registered Nurse | RN186954 (Arizona) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Bhsm Rehabilitation Llc | 2062773138 | 1575 |
| Lakeside Heart And Vascular Center Pllc | 4587832779 | 27 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Traci Moore allows following entities to bill medicare on her behalf.
| Entity Name | Lakeside Heart And Vascular Center Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1801194352
PECOS PAC ID: 4587832779
Enrollment ID: O20110713000658 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Traci Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Traci Moore, APRN, FNP-C
3931 N Stockton Hill Rd,
Kingman, AZ 86409-2426
Ph: (928) 385-7100 | Traci Moore, APRN, FNP-C
3931 N Stockton Hill Rd,
Kingman, AZ 86409-2426
Ph: (928) 385-7100 |
Reviews and Comments