Individual provider Active NPI

Jonathan M Moore, DPM

  • Podiatrist
  • Cincinnati, OH
National Provider Identifier
1063670602
Registry record updated Dec 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003490 Issued in OH
Practice address
3248 Westbourne Dr Ste 1
Cincinnati, OH 45248-5146
Phone
(513) 662-3900
Fax
(513) 662-3933
NPI assigned
May 30, 2008
Last updated
Dec 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 36003490 OH Primary

Addresses

Primary practice location

3248 Westbourne Dr Ste 1
Cincinnati, OH 45248-5146

Mailing address

32743 23 Mile Rd Ste 210
Chesterfield, MI 48047-2176
Phone (708) 424-3201

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20080807000006 OH Practitioner - Podiatry 0840364964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11100 State Route 41
West Union, OH 45693-8806
Phone (937) 544-0400

230 Medical Ctr Dr
Seaman, OH 45679-8002
Phone (937) 386-3400

4881 State Route 125
Georgetown, OH 45121-9550
Phone (937) 378-3075

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue158
Removal or shaving of skin growth12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Regional Medical Center CurrentSince Mar 16, 2023 Accepting new patients
Adams County Regional Medical Center CurrentSince Mar 16, 2023 Accepting new patients
Adams County Regional Medical Center Current Accepting new patients
Adams County Regional Medical Center Past Accepting new patients
Lindenwald Medical Associates Inc PastSince Mar 1, 2015 Accepting new patients
Adams County Regional Medical Center Past Accepting new patients
Centers for Foot & Ankle Care LLC Past Accepting new patients
Centers for Foot & Ankle Care LLC Past Accepting new patients

Locations

4881 State Route 125
Georgetown, OH 45121
Phone (937) 378-2526

217 Hughes Blvd
Mount Orab, OH 45154
Phone (937) 346-8826

230 Medical Center Dr
Seaman, OH 45679
Phone (937) 386-3400

Interoperability endpoints

  • Direct secure messaging: jmoore34281@direct.uchealth.com
  • Direct secure messaging: jonathan.moore.1@18549.direct.athenahealth.com
  • Direct secure messaging: jonathan.moore@cffaacl-oh.direct.office.nextgen.com

Organizations & group practices 8

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 2

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670112000000",
    "number": "1063670602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32743 23 MILE RD STE 210",
            "city": "CHESTERFIELD",
            "state": "MI",
            "postal_code": "480472176",
            "telephone_number": "708-424-3201",
            "fax_number": "708-424-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 WESTBOURNE DR STE 1",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452485146",
            "telephone_number": "513-662-3900",
            "fax_number": "513-662-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JONATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-30",
        "last_updated": "2022-12-04",
        "certification_date": "2022-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.