Individual provider Active NPI

Durward Troy Moon, MD

  • Pediatric Infectious Diseases Physician
  • New Orleans, LA
National Provider Identifier
1063488864
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD.025870 Issued in LA
Practice address
200 Henry Clay Ave
New Orleans, LA 70118-5798
Phone
(504) 899-9511
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Infectious Diseases Physician 2080P0208X 0000042693 TN
Pediatric Infectious Diseases Physician 2080P0208X MD.025870 LA Primary

Addresses

Primary practice location

200 Henry Clay Ave
New Orleans, LA 70118-5798

Mailing address

200 Henry Clay Ave
New Orleans, LA 70118-5798
Phone (504) 899-9511

Other names 1

  • Dr. Troy Moon Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20230316001517 LA Practitioner - Pediatric Medicine 0446484612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Medical Practice CorporationGroup PAC ID 5597944579, 48 clinicians

Practice addresses (Care Compare)

4740 S I 10 Service Rd W
200 Children'S Hospital Specialty Care
Metairie, LA 70001-1244
Phone (504) 988-6253

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000042693TNMDPediatric Infectious Diseases Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Medical Practice Corporation Pediatrics CurrentSince Mar 19, 2023 Accepting new patients
Administrators of the Tulane Educational Fund Current Accepting new patients
Administrators of the Tulane Education Fund CurrentSince Jan 1, 2023 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Jan 1, 2023 Accepting new patients

Locations

141 Ormond Center Ct
Destrehan, LA 70047
Phone (985) 764-7337

4740 S I 10 Service Rd W
Ste 200
Metairie, LA 70001
Phone (504) 988-5458

3040 33rd St
Metairie, LA 70001
Phone (504) 219-0880

1430 Tulane Ave
#8637
New Orleans, LA 70112

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1063488864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185798",
            "telephone_number": "504-899-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185798",
            "telephone_number": "504-899-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "DURWARD",
        "middle_name": "TROY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "TN",
            "license": "0000042693",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "LA",
            "license": "MD.025870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TROY",
            "last_name": "MOON",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.