Samantha Jordan Moore, PT, DPT in Davis, CA - Medicare Physical Therapist Provider

Samantha Jordan Moore, PT, DPT is a medicare enrolled "Physical Therapist" provider in Davis, California. Her current practice location is 1460 Drew Ave Ste 200, Davis, California. You can reach out to her office (for appointments etc.) via phone at (530) 304-5169.

Samantha Jordan Moore is licensed to practice in California (license number 308028) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1003606963.

Contact Information

	Samantha Jordan Moore, PT, DPT
	1460 Drew Ave Ste 200, Davis, CA 95618-4856
	(530) 304-5169
	(530) 753-9021

Map and Direction

Healthcare Provider's Profile

Full Name	Samantha Jordan Moore
Gender	Female
Speciality	Physical Therapist
Location	1460 Drew Ave Ste 200, Davis, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1003606963
Provider Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025

Medicare PECOS Information:

PECOS PAC ID: 1254850555
Enrollment ID: I20250529001255

Medical Identifiers

Medical identifiers for Samantha Jordan Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1003606963	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	308028 (California)	Primary

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. Samantha Jordan Moore allows following entities to bill medicare on her behalf.

Provider Name	Physical Edge, Inc.
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1770675639 PECOS PAC ID: 7214990399 Enrollment ID: O20041109001110

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. Samantha Jordan 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
Samantha Jordan Moore, PT, DPT 1460 Drew Ave Ste 200, Davis, CA 95618-4856 Ph: (530) 304-5169	Samantha Jordan Moore, PT, DPT 1460 Drew Ave Ste 200, Davis, CA 95618-4856 Ph: (530) 304-5169

Reviews and Comments

Physical Therapist in Davis, CA

Audrey Mott, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2035 Lyndell Ter Ste 200, Davis, CA 95616 Phone: 530-758-2222
Alyssa Borchert, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1500 Shasta Dr Apt 135, Davis, CA 95616 Phone: 808-292-1051
Daniel Martin, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3002 Ponteverde Ln, Davis, CA 95618 Phone: 530-758-1508 Fax: 530-758-1508
Jolie Gonzalez, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2035 Lyndell Ter, Suite 200, Davis, CA 95616 Phone: 530-758-2222
Dr. Leigh Quill, D.P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1340 Lake Blvd, Davis, CA 95616 Phone: 530-753-5338 Fax: 530-753-4609
Jennifer Ferguson Rhoads, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1340 Lake Blvd, Davis, CA 95616 Phone: 530-753-5338 Fax: 530-753-4609

Samantha Jordan Moore, PT, DPT - Medicare Physical Therapist in Davis, CA