NPIMap

Individual provider Active NPI

Jeffrey Moore, M.D.

  • Internal Medicine Physician
  • Stephenville, TX
National Provider Identifier
1023014008
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
E04475 Issued in TX
Practice address
150 River North Blvd
Stephenville, TX 76401-1803
Phone
(254) 968-6051
Fax
(254) 968-4204
NPI assigned
Jun 23, 2005
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E04475 TX Primary

Addresses

Primary practice location

150 River North Blvd
Stephenville, TX 76401-1803

Mailing address

150 River North Blvd
Stephenville, TX 76401-1803
Phone (254) 968-6051

Other identifiers 7

IdentifierTypeStateIssuer
160023077OtherTNRAILROAD MEDICARE
119780100OtherTXFIRST CARE PROVIDER NUMBE
4458949OtherTXAETNA PROVIDER NUMBER
70490001OtherTXUNITED HEALTHCARE PROV NO
814762OtherTXBCBS PROVIDER NUMBER
101877201MedicaidTX
2462125003OtherTXCIGNA PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091215000237 TX Practitioner - Internal Medicine 9931194826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Southwestern Medical School at Dallas, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Care PLLCGroup PAC ID 7214840867, 363 clinicians

Practice addresses (Care Compare)

150 River N Blvd
Privia Medical Group North Texas
Stephenville, TX 76401-1860
Phone (254) 968-6051

160 River N Blvd
Privia Medical Group North Texas
Stephenville, TX 76401-1803
Phone (254) 968-6051

6700 Buenos Aires Dr
N Richland Hills, TX 76180-6566
Phone (817) 281-8245

920 Santa Fe Dr
Suite 103
Weatherford, TX 76086-5865
Phone (817) 339-8855

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.51 of 100Reported as apm
Quality
85.62
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E04475TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. CurrentSince Jun 18, 2019 Accepting new patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. Internal Medicine CurrentSince Jun 18, 2019 Accepting new patients
Winnie-Stowell Hospital District Past Accepting new patients
Rock House Support Services, Inc. Past Accepting new patients

Locations

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

150 River North Blvd
Stephenville, TX 76401
Phone (254) 965-9729

920 Santa Fe Dr
Ste 103
Weatherford, TX 76086
Phone (817) 339-8855

Interoperability endpoints

  • Direct secure messaging: jeffrey.moore.p1@direct.thc.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Health ClinicStephenville, TX, CCN 453862 Rural health clinic General Partnership Interest (14.28%) Nov 16, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1023014008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 RIVER NORTH BLVD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011803",
            "telephone_number": "254-968-6051",
            "fax_number": "254-968-4204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 RIVER NORTH BLVD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011803",
            "telephone_number": "254-968-6051",
            "fax_number": "254-968-4204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "E04475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160023077",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE PROVIDER NUMBE",
            "identifier": "119780100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4458949",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE PROV NO",
            "identifier": "70490001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "814762",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101877201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "2462125003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.