Jacob Bradley Moore

Primary specialty

OptometristTaxonomy code 152W00000X

License

2021020987 Issued in MO

Practice address

500 N Keene St
Suite 103
Columbia, MO 65201-8104

Phone

(573) 874-2030

Fax

(573) 449-0253

NPI assigned

Jun 11, 2021

Sex

Male

Sole proprietor

Yes

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 MO, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Helfrich Family Eye Care, LLCGroup PAC ID 8224225115, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.71 of 100Reported as group

Quality

95.95

Improvement activities

40

Cost

77.77

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.moore1@direct.revolutionehr.com

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.

• Helfrich Family Eye Care, LLC

  • Optometrist
  • Fairview Heights, IL
  • NPI 1134432248
  Medicare reassignment Care Compare group NPD
• Columbia Eye Consultants Optometry

  • Optometrist
  • Columbia, MO
  • NPI 1346396033
  Medicare reassignment NPD
• Columbia Eyewear

  • Optician
  • Columbia, MO
  • NPI 1720134513
  NPD (past)
• Iha Health Services Corporation

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1124425285
  NPD (past)

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1063080554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-874-2030",
            "fax_number": "573-449-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N KEENE ST",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652018104",
            "telephone_number": "573-874-2030",
            "fax_number": "573-449-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACOB",
        "middle_name": "BRADLEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2021020987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciara Moore
• Don K Moore, M.D.
• Ellen Moore, LMSW
• Emily Moore, CRT
• Erika Moore, COTA
• James Leroy Moore
• Jania Ayrie Moore
• Joshua Steven Moore, PHARMD.
• Kelli Jo Moore, M.D.
• Kelly Moore, DO

• Optometrist in Columbia, MO
• Providers in Columbia, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.