CMS-1500 Box 24J / 33a • NPI
1154339661
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
111N00000X (CMS 35)
Licensed & Credentialed Chiropractic Providers — Chiropractor
Box 32 Service Location & ZIP+4
500 E FLORIDA ST, HOLBROOK, AZ, 86025-2724
✓ 9-Digit EDI 837 ZIP+4 (86025-2724)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1154339661 (MATHEW DAVID MOORE, D.C.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1154339661)
Medicare Beneficiaries
12
Total Billed Services
49
Distinct CPT/HCPCS Codes
1
Medicare Allowed Total
$1,870.71
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
98941 | Chiropractic manipulative treatment, 3-4 spinal regions | 49 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1154339661 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MATHEW DAVID MOORE, D.C. |
| Plain-English Specialty | Licensed & Credentialed Chiropractic Providers — Chiropractor NUCC Code: 111N00000X (Chiropractor) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 500 E FLORIDA ST, HOLBROOK, AZ, 86025-2724 |
| Practice Telephone / Fax | Tel: (928) 524-1900 |
| Administrative Mailing Address | 500 E FLORIDA ST, HOLBROOK, AZ, 86025-2724 |
| Enumeration & Last Sync | Enumerated: 2006-08-03 | CMS Record Updated: 2012-05-02 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (111N00000X)
What Does Taxonomy Code 111N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 111N00000X translates to:
"Licensed & Credentialed Chiropractic Providers — Chiropractor"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MATHEW DAVID MOORE, D.C.)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: AZ | License: 5746AZ | Primary: Yes (Primary) |
111N00000X — ChiropractorPlain English: Licensed & Credentialed Chiropractic Providers — Chiropractor | State: CO | License: CHR4245 | Primary: Secondary |
Medical Billing, RCM & Hospital Credentialing Teams:
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