Luke Tae Jong Moore, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

63520 Issued in MN

Practice address

400 E 3Rd St
Duluth, MN 55805-1951

Phone

(218) 786-8364

NPI assigned

Apr 19, 2013

Last updated

Jan 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, GU, NV3 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

Specialty

Ophthalmology

Education

Drexel University College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shepherd Eye Center LTDGroup PAC ID 9234125907, 42 clinicians

Island Eye CenterGroup PAC ID 3375444920, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Island Eye Center

  dba Island Eye Institute

  • Ophthalmology Physician
  • Tamuning, GU
  • NPI 1487772000
  Medicare reassignment Care Compare group NPD
• Shepherd Eye Center, LTD

  dba Nevada Eye Physicians

  • Ophthalmology Physician
  • Las Vegas, NV
  • NPI 1487604054
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  dba HealthPartners Medical Group

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Midway Residency Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Shepherd Eye Center, LTD

  dba Nevada Eye Physicians

  • Ophthalmology Physician
  • Henderson, NV
  • NPI 1568032522
  NPD
• Shepherd Eye Center, LTD

  dba New Eyes

  • Ophthalmology Physician
  • Las Vegas, NV
  • NPI 1902478449
  NPD
• Shepherd Eye Center, LTD

  dba NV Eye Surgery

  • Ophthalmology Physician
  • Henderson, NV
  • NPI 1881321388
  NPD (past)

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1023452182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-783-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Gresham Dr",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071904",
            "country_code": "US",
            "telephone_number": "757-388-0324",
            "fax_number": "757-388-0355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LUKE",
        "middle_name": "TAE JONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-19",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MN",
            "license": "63520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cade Richard Montgomery
• Claire Elizabeth Ann Montgomery, LPCC
• Disha Mookherjee, M.D.
• Cielo A Mooney, CCC/SLP
• Charles R Moore, MD
• Marilyn Joyce Moore, RN
• Reynard K Moore
• Ashley Therese Moos, MS
• Arrin Leigh Moran
• Brian Patrick Moran, MD

• Ophthalmology Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Ophthalmology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.