Individual provider Active NPI

Michelle Nicole Moe-Aiken, M.D.

  • Vascular Surgery Physician
  • Keller, TX
National Provider Identifier
1043672074
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
31956 Issued in MS
Practice address
1109 Jericho CT
Keller, TX 76262-9391
Phone
(817) 368-6236
NPI assigned
Mar 29, 2016
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 31956 MS Primary

Addresses

Primary practice location

1109 Jericho CT
Keller, TX 76262-9391

Mailing address

1109 Jericho CT
Keller, TX 76262-9391
Phone (817) 368-6236

Other names 1

  • Michelle Nicole Moe Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, KY2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20231019003344 MS Practitioner - Vascular Surgery 4284036237 Reassigns benefits to 1 organization
I20250724000552 KY Practitioner - Vascular Surgery 4284036237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Texas Southwestern Medical School at Dallas, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Hospital Dr
FL 1
Madisonville, KY 42431-1658
Phone (270) 326-3800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.34 of 100Reported as group
Quality
96.39
Improvement activities
40
Cost
69.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Deaconess Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients
Advanced Vascular and Vein Associates, LLC Vascular Surgery CurrentSince Aug 1, 2023 Accepting new patients
North Mississippi Medical Center Current Accepting new patients
Baptist Health Deaconess Medical Group Inc Current Accepting new patients
Baptist Health Deaconess Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients

Locations

800 Hospital Dr
Fl 1
Madisonville, KY 42431
Phone (270) 326-3800

800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900

4436 Mangum Dr
Flowood, MS 39232
Phone (601) 586-7070

778 Liberty Rd
Flowood, MS 39232
Phone (601) 326-1794

830 S Gloster St
Fl 4
Tupelo, MS 38801
Phone (662) 377-7100

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: michellemoe-aiken@nmhs.medalliesdirect.net
  • Direct secure messaging: mmoeaiken5277248@direct.casso.us.com

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 1

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1043672074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 JERICHO CT",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762629391",
            "telephone_number": "817-368-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 JERICHO CT",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762629391",
            "telephone_number": "817-368-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE-AIKEN",
        "first_name": "MICHELLE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "31956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MOE",
            "middle_name": "NICOLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

Verify at the official NPI Registry.