Individual provider Active NPI

Julie A Moore, M.D.

  • Dermatology Physician
  • Melrose Park, IL
National Provider Identifier
1053373589
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036075509 Issued in IL
Practice address
501 W North Ave Ste 103
Melrose Park, IL 60160-1603
Phone
(708) 450-5086
NPI assigned
Apr 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036075509 IL Primary

Addresses

Primary practice location

501 W North Ave Ste 103
Melrose Park, IL 60160-1603

Mailing address

501 W North Ave Ste 103
Melrose Park, IL 60160-1603
Phone (708) 450-5086

Other identifiers 1

IdentifierTypeStateIssuer
036075509MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address JulieMoore@moore.emadirect.md
Direct Messaging Address JulieMoore@moore.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040608000516 IL Practitioner - Dermatology 1658353388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Creighton University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Moore Dermatology SCGroup PAC ID 1254313984, 2 clinicians

Practice addresses (Care Compare)

501 W N Ave
Suite 103
Melrose Park, IL 60160-1677
Phone (708) 450-5086

Hospital & facility affiliations

  • Loyola Gottlieb Memorial Hospital Hospital, Melrose Park, IL, CCN 140008

Merit-based Incentive Payment System (MIPS)

Final score
74.53 of 100Reported as individual
Quality
73.33
Promoting interoperability
64
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1175
Skin biopsy503

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Dermatology SC Dermatology CurrentSince Jan 1, 2004 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Tracy Campbell MD LLC Dermatology Current Accepting new patients
Dupage Medical Group LTD Past Accepting new patients
Rush University Medical Center Past Accepting new patients

Locations

501 W North Ave
Ste 103
Melrose Park, IL 60160
Phone (708) 450-5086

701 W North Ave
Melrose Park, IL 60160
Phone (708) 450-5779

Interoperability endpoints

  • Direct secure messaging: jmoore50902@direct.luhs.org
  • Direct secure messaging: juliemoore@moore.emadirect.md

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 and National Provider Directory roles.

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1053373589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W NORTH AVE STE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601603",
            "telephone_number": "708-450-5086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W NORTH AVE STE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601603",
            "telephone_number": "708-450-5086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036075509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036075509",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JulieMoore@moore.emadirect.md",
            "affiliation": "N",
            "address_1": "501 W North Ave Ste 103",
            "city": "Melrose Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601601603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JulieMoore@moore.emadirect.md",
            "affiliation": "N",
            "address_1": "501 W North Ave Ste 103",
            "city": "Melrose Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601601603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melrose Park, IL

Sources for this page

Verify at the official NPI Registry.