Randy Ranshawn Moore, PA-C - Medicare Physician Assistant in Longview, TX

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Randy Ranshawn Moore, PA-C is a medicare enrolled "Physician Assistant" in Longview, Texas. His current practice location is 425 N Fredonia St, Longview, Texas. You can reach out to his office (for appointments etc.) via phone at (903) 758-2610.

Randy Ranshawn Moore is licensed to practice in Texas (license number PA07050) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1053627265.

Contact Information

Randy Ranshawn Moore, PA-C
425 N Fredonia St,
Longview, TX 75601-6464
(903) 758-2610
(903) 758-7081

Map and Direction




Provider's Profile

Full NameRandy Ranshawn Moore
GenderMale
SpecialityPhysician Assistant
Location425 N Fredonia St, Longview, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1053627265
  • Provider Enumeration Date: 08/25/2010
  • Last Update Date: 08/26/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 6103941844
  • Enrollment ID: I20100917000520

Medical Identifiers

Medical identifiers for Randy Ranshawn Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053627265NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical PA07050 (Texas)Secondary
363AS0400XPhysician Assistant - Surgical PA07050 (Texas)Secondary
363A00000XPhysician Assistant PA07050 (Texas)Primary
363A00000XPhysician Assistant (* (Not Available))Secondary

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. Randy Ranshawn Moore allows following entities to bill medicare on his behalf.
Entity NameLongview Wellness Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942269493
PECOS PAC ID: 1254367766
Enrollment ID: O20050714001046
Entity NameSignify Health Medical Associates PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20190520001486
Entity NameNorth Texas Physician Services, PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1992586150
PECOS PAC ID: 6305295429
Enrollment ID: O20231213004113
Entity NameTyler Physician Services PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1225898034
PECOS PAC ID: 3678912870
Enrollment ID: O20240422000594

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. Randy Ranshawn 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 AddressPractice Location Address
Randy Ranshawn Moore, PA-C
1107 E Marshall Ave,
Longview, TX 75601-5602

Ph: (903) 758-2610		Randy Ranshawn Moore, PA-C
425 N Fredonia St,
Longview, TX 75601-6464

Ph: (903) 758-2610

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.