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

Roger L. Moore, PA

Individual provider Physician Assistant · NPI 1295793099

Roger L. Moore, PA is a Physician Assistant in Tulsa, Oklahoma. Qualified in 2004, 22 years ago. Practices with St John Urgent Care Clinics Inc, a 30-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
22
Licensed in
OK
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2929 S Garnett Rd C/o Medcenter
Tulsa, OK 74129-5101
Phone: (918) 665-1520
Fax: (405) 749-4561
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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 1378 (OK)

Record details

NPI number1295793099
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 2, 2006
Last updated in NPPESMay 1, 2008
Mailing addressPo Box 22063, Dept 0289, Tulsa, OK 74121-2063

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice St John Urgent Care Clinics Inc — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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