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

Jacob Daniel Moore

Individual provider Physical Therapist · NPI 1568342699

Jacob Daniel Moore is registered under Physical Therapist in Private Practice in Indianapolis, Indiana. Qualified in 2025, 1 year ago. Practices with Advanced Physical Therapy LLC, a 170-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
1
Licensed in
IN
In the registry since
2025
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Practice location Address checks out

4625 S Emerson Ave Ste D
Indianapolis, IN 46203-5990
Phone: (317) 677-0202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X (IN)

Record details

NPI number1568342699
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 8, 2025
Last updated in NPPESSeptember 8, 2025
Certification dateSeptember 8, 2025

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 Advanced Physical Therapy Llc — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Advanced Physical Therapy LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 170 clinicians in the practice; 12 are shown here.

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