Martha Jane Moore, MD-MPH

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

6678 Issued in AK

Practice address

3223 E Palmer Wasilla Hwy Ste 4
Wasilla, AK 99654-7277

Phone

(907) 631-6300

Fax

(907) 631-6314

NPI assigned

Sep 20, 2006

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

Other identifiers 1

Other names 1

• Dr. M Jane Moore Professional name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoore@direct.scf.cc

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.

• Alaska Native Tribal Health Consortium

  • General Acute Care Hospital
  • Anchorage, AK
  • NPI 1437189339

  TX

  Medicare reassignment NPD
• Metlakatla Indian Community

  • Health Service Clinic/Center
  • Metlakatla, AK
  • NPI 1740294081

  TX

  Medicare reassignment NPD
• Southcentral Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • McGrath, AK
  • NPI 1780614263

  TX

  Medicare reassignment NPD
• Southcentral Foundation

  • Community/Behavioral Health Agency
  • Anchorage, AK
  • NPI 1235782657
  NPD
• Gustavus Community Clinic Inc

  • Family Nurse Practitioner
  • Gustavus, AK
  • NPI 1548281215
  NPD (past)
• M. Jane Moore, MD. LLC.

  • Primary Care Clinic/Center
  • Anchorage, AK
  • NPI 1609173798
  NPD (past)
• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Soldotna, AK
  • NPI 1700984614

  Family Medicine

  NPD (past)
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Gustavus, AK
  • NPI 1649716226
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1053418921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 E PALMER WASILLA HWY STE 4",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547277",
            "telephone_number": "907-631-6300",
            "fax_number": "907-631-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 E PALMER WASILLA HWY STE 4",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547277",
            "telephone_number": "907-631-6300",
            "fax_number": "907-631-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARTHA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "MD-MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "AK",
            "license": "6678",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AK",
            "license": "3944",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD8920",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M JANE",
            "last_name": "MOORE",
            "prefix": "DR.",
            "credential": "MD-MPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna Moore, OTR/L
• Darrell Moore
• Jennifer Moore
• John Wayne Moore, PA-C
• Judith Moore
• Mary Jane Moore
• Stace Lee Elizabeth Moore, LMT
• William Robert Moore
• Moose Creek Medical Clinic LLC
• Pamela S Mooty

• Addiction Medicine (Family Medicine) Physician in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Addiction Medicine (Family Medicine) Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.