Active NPI
Kyle Von Moore, D.O.
- Family Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1154785616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11273463-1204
- Practice address
- 501 S Chipeta Way
Salt Lake City, UT 84108-1222 - Phone
- (801) 581-7951
- NPI assigned
- Apr 11, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 62587 | MN | |
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 11273463-1204 | UT | |
| Family Medicine Physician | 207Q00000X | 11273463-1204 | UT | Primary |
Addresses
Primary practice location
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Mailing address
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 581-7951
Other practice location 1
200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Pacific NW Un of HS, Col of Osteopathic Medicine, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2550 E Broadway St
Helena, MT 59601-4905
Phone (406) 447-2828
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.75 of 100
- Quality
- 71.01
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.84
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62587 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah Community Physicians Group | Family Medicine | Current | Accepting new patients |
| St Peter'S Health | Current | Accepting new patients | |
| St Peters Hospital | Current | Accepting new patients | |
| St. Peter'S Health | Current | Accepting new patients | |
| St. Peter'S Health | Family Medicine | Past | Accepting new patients |
Locations
2550 E Broadway St
Helena, MT 59601
Phone (406) 495-6805
2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480
1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841
501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Helena, MT
- NPI 1205025145
-
dba UUHC - Redstone Center
- Family Medicine Physician
- Park City, UT
- NPI 1053715763
-
dba St Peters Medical Office Building
- Family Medicine Physician
- Helena, MT
- NPI 1083869390
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Peters Medical Office Building
- Family Medicine Physician
- Helena, MT
- NPI 1083869390
Hospital
-
- General Acute Care Hospital
- Helena, MT
- NPI 1528023520
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1154785616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-581-7951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 S CHIPETA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081222",
"telephone_number": "801-581-7951"
}
],
"practiceLocations": [
{
"address_1": "200 1st St SW",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MN",
"postal_code": "559050001",
"country_code": "US",
"telephone_number": "507-284-2511",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "KYLE",
"middle_name": "VON",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-11",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "62587",
"primary": false
},
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "UT",
"license": "11273463-1204",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "UT",
"license": "11273463-1204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.