Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1982224796 Individual Practitioner Male Practitioner

Dr. Shane Edward Moore , DO

Surgery • Prescott Valley, AZ

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Shane Moore, DO is a certified Surgery practicing in Prescott Valley, AZ. With approximately 6 years of clinical experience since graduating from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2020, Dr. Moore delivers high-quality medical care to the local community at 7700 E FLORENTINE RD STE 203.

Dr. Moore is affiliated with Yavapai Regional Medical Center Physician Care Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

7700 E Florentine Rd Ste 203

Prescott Valley, AZ 863142245

Telephone 9287084310
Fax 9285482164
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

At Still University Of Health Sciences, College Of Osteo Med, Kirksville

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Prescott Valley, AZ

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs -25.3 yrs vs City Avg
City Avg: 31.3 Yrs
State Avg: 23.6 Yrs
Regional Practice Density
5 Specialists

Practicing in Prescott Valley, AZ (801 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Moore (6 Years) 6 Yrs
Prescott Valley Specialty Average (31.3 Years) 31.3 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-06-03
Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License AZ 011620

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Hospital & Practice Group Affiliations

Yavapai Regional Medical Center Physician Care Llc

7700 E Florentine Rd, Prescott Valley, AZ 863142245

Phone: 9284428740

Secondary Practice Locations

1301 S Crismon Rd

Mesa, AZ 852093767

Phone: 4803586450

1001 Willow Creek Rd Ste 1200

Prescott, AZ 863011614

Phone: 9284582995

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location June 03, 2025

Registered at 7700 E FLORENTINE RD STE 203, PRESCOTT VALLEY, AZ 863142245 (Tel: 9287084310)

📍
Updated Business Mailing Address June 03, 2025

Registered at PO BOX 10880, PRESCOTT, AZ 863040880 (Tel: 6024064786)

NPI Profile Active April 22, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location April 22, 2020

Registered at 1301 S CRISMON RD, MESA, AZ 852093767 (Tel: 4803586450)

📍
Updated Business Mailing Address April 22, 2020

Registered at 1116 FRANKLIN AVE, NORMAL, IL 617613514

👤
Provider Name / Credentials Updated April 22, 2020

Recorded as SHANE MOORE, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 22, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 22, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982224796
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 22, 2020
Last Update: June 03, 2025
Sole Proprietor: No

Mailing Address

Po Box 10880

Prescott, AZ 863040880

Phone: 6024064786

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.