Individual provider Active NPI

Gregory J Moore, MD

  • Emergency Medicine Physician
  • Dillon, MT
National Provider Identifier
1144315573
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
6607 Issued in MT
Practice address
600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone
(406) 683-3051
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 6607 MT Primary

Addresses

Primary practice location

600 Mt Highway 91 S
Dillon, MT 59725-7379

Mailing address

90 Hwy 91 South
Dillon, MT 59725
Phone (406) 683-3051

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address GMOORE214667@WM.PROVIDENCEDIRECT.ORG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040914001399 MT Practitioner - Emergency Medicine 3971415464 Reassigns benefits to 2 organizations
I20110405000923 ID Practitioner - Emergency Medicine 3971415464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio State University College of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 Mt Hwy 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6607MTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steele Memorial Medical Center CurrentSince Mar 31, 2006 Accepting new patients
Barrett Hospital Development Corporation CurrentSince Apr 1, 2021 Accepting new patients
Steele Memorial Medical Center CurrentSince Mar 31, 2006 Accepting new patients
Barrett Hospital Development Corporation CurrentSince Apr 1, 2021 Accepting new patients
Madison Valley Hospital Inc Past Accepting new patients
Community Medical Center Inc Past Accepting new patients
Clark Fork Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Locations

203 S Daisy St
Salmon, ID 83467
Phone (208) 756-4291

30 MT Highway 91 S
Dillon, MT 59725
Phone (406) 414-5070

600 MT Highway 91 S
Dillon, MT 59725
Phone (406) 683-3001

Interoperability endpoints

  • Direct secure messaging: gmoore214667@wm.providencedirect.org

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 and National Provider Directory roles.

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1144315573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HWY 91 SOUTH",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "59725",
            "telephone_number": "406-683-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MT HIGHWAY 91 S",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597257379",
            "telephone_number": "406-683-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GREGORY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "6607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "GMOORE214667@WM.PROVIDENCEDIRECT.ORG",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dillon, MT

Sources for this page

Verify at the official NPI Registry.