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

Jacob A Moore, PT

Individual provider Physical Therapist · NPI 1770469603

Jacob A Moore, PT is a Physical Therapist in Private Practice in Bernalillo, New Mexico. Qualified in 2025, 1 year ago. Practices with Balanced Physical Therapy and Wellness LLC, a 50-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

240 S Camino Del Pueblo
Bernalillo, NM 87004-6076
Phone: (505) 373-2836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1770469603
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedAugust 14, 2025
Last updated in NPPESAugust 14, 2025
Certification dateAugust 14, 2025
Mailing address7849 Tramway Blvd Ne Ste A, Albuquerque, NM 87122-2529

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Balanced Physical Therapy And Wellness Llc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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