Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael Kevin Moore, MD, MS

Individual provider Neurological Surgery Physician · NPI 1306136452

Dr. Michael Kevin Moore, MD, MS is a Neurosurgery in Reno, Nevada. Graduated from Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University in 2011, 15 years ago. Practices with Custom Physical Therapy Limited Partnership, a 81-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
15
Trained at
Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University
Licensed in
WA
In the registry since
2011
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

5590 Kietzke Ln
Reno, NV 89511
Phone: (775) 323-2080
Fax: (775) 323-8216
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1365b Clifton Rd Ne, Atlanta, GA 30322 — (404) 778-5969

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence MD60815224 (WA)

Record details

NPI number1306136452
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MS
Sole proprietorNo
NPI enumeratedApril 11, 2011
Last updated in NPPESOctober 24, 2019
Mailing address5590 Kietzke Ln, Reno, NV 89511-3019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNEUROSURGERY
Medical schoolCLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated 2011 (15 years in practice)
Group practice Custom Physical Therapy Limited Partnership — 81 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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