Trudy J Moore, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

16333 Issued in OK

Practice address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Phone

(952) 595-1301

Fax

(612) 294-4903

NPI assigned

Nov 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK, TX, AR3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Fred Smeltzer MD & Associates Inc

  • Diagnostic Radiology Physician
  • Osage Beach, MO
  • NPI 1639122286

  AR, OK

  Medicare reassignment NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Thorne Bay, AK
  • NPI 1376758037

  TX

  Medicare reassignment NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Juneau, AK
  • NPI 1427941343
  NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Point Baker, AK
  • NPI 1881130276
  NPD
• Ohio Imaging Associates Inc

  • Diagnostic Radiology Physician
  • Seaman, OH
  • NPI 1982745618
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Diagnostic Radiology

  NPD (past)
• R and a Radiology LLP

  • Diagnostic Radiology Physician
  • Fort Smith, AR
  • NPI 1750349247
  NPD (past)
• Radadvantage a Professional Corporation

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1376719666
  NPD (past)
• Radiology Services P a

  • Diagnostic Radiology Physician
  • Ft Smith, AR
  • NPI 1154301786
  NPD (past)
• South East Alaska Regional Health Consortium

  • Clinic/Center
  • Wrangel, AK
  • NPI 1487836391
  NPD (past)

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1023099488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRUDY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "16333",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "C-5845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Monroe, P.T.
• Michael D Montgomery, M.D.
• Timothy J. Montgomery, DDS
• Kate M Moon
• Kimberly Evans Moore, PHARMD, RDN
• Andrew Moran, DPT
• Aaron R Morland, DC
• David S Morrell, MD
• Lianna Valerie Morrow, DC
• Mosaic Therapeutic Services LTD.

• Diagnostic Radiology Physician in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Diagnostic Radiology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.