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

Mr. Kevin Matthew Moore, PA-C

Individual provider Physician Assistant · NPI 1619673316

Mr. Kevin Matthew Moore, PA-C is a Physician Assistant in San Antonio, Texas. Qualified in 2022, 4 years ago. Practices with Wellmed Medical Group PA, a 664-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
4
Licensed in
TX
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

448 Castroville Rd
San Antonio, TX 78207-5147
Phone: (210) 434-1400
Fax: (210) 431-7472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA16479 (TX)

Record details

NPI number1619673316
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 3, 2023
Last updated in NPPESFebruary 3, 2023
Certification dateFebruary 3, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Wellmed Medical Group Pa — 664 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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