Erin M Moore, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

ME101863 Issued in FL

Practice address

836 Prudential Dr
Ste 1804
Jacksonville, FL 32207

Phone

(904) 398-3888

Fax

(904) 400-6675

NPI assigned

Aug 1, 2005

Last updated

Nov 23, 2022By 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

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, GA, PA3 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

Vascular Surgery

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiothoracic and Vascular Surgical Associates PAGroup PAC ID 5395725188, 85 clinicians

Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tift Regional Medical Center Hospital, Tifton, GA, CCN 110095

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: erin.moore.jax@direct.vac.nextgenshare.com
• Direct secure messaging: erinmoore@cvsapa.allscriptsdirect.net

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.

• Cardiothoracic & Vascular Surgical Associates PA

  • Vascular & Interventional Radiology Physician
  • Jacksonville, FL
  • NPI 1851403125

  Vascular Surgery

  Medicare reassignment Care Compare group NPD
• Tift Regional Health System Inc

  dba Southwell Mobile Clinic

  • Family Medicine Physician
  • Tifton, GA
  • NPI 1881203305
  Medicare reassignment Care Compare group NPD
• Penn State Health Medical Group, LLC

  • Hematology & Oncology Physician
  • Harrisburg, PA
  • NPI 1861988644
  Medicare reassignment NPD
• St. Joseph Medical Group

  • Family Medicine Physician
  • Reading, PA
  • NPI 1184754657

  Vascular Surgery

  Medicare reassignment NPD
• Penn State Health Medical Group, LLC

  • Cardiovascular Disease Physician
  • Camp Hill, PA
  • NPI 1134874779
  NPD
• Penn State Health Medical Group, LLC

  • Diagnostic Radiology Physician
  • Harrisburg, PA
  • NPI 1457824013
  NPD
• St. Joseph Medical Group

  • Anesthesiology Physician
  • Reading, PA
  • NPI 1841680881
  NPD
• Tift Regional Health System Inc

  dba WorkSmart Occupational Medicine

  • Clinic/Center
  • Tifton, GA
  • NPI 1003980996
  NPD
• Tift Regional Health System Inc.

  dba Tift Regional Medical Center

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  NPD

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

• Tift Regional Health System Inc.

  dba Tift Regional Medical Center

  • General Acute Care Hospital
  • Tifton, GA
  • NPI 1962462226
  Care Compare affiliation

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1033119037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 KING ST",
            "address_2": "STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044735",
            "telephone_number": "904-384-3343",
            "fax_number": "904-400-6671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR",
            "address_2": "STE 1804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-398-3888",
            "fax_number": "904-400-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ERIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME101863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167164085A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00718847",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000999700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "erinmoore@cvsapa.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "836 Prudential Dr",
            "address_2": "Ste 1804",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher William Moore
• Courtney Moore
• Elizabeth Moore, PT, DPT
• Elizabeth Moore
• Erin Moore
• Ireanna Moore
• Jaimya Moore
• James Scott Moore, DC
• Jane Moore, LMT
• Jasmine Moore

• Vascular Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.