Individual provider Active NPI

Tricia Moo-Young, M.D.

  • Surgery Physician
  • Evanston, IL
National Provider Identifier
1215952650
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.123221 Issued in IL
Practice address
2650 Ridge Ave
Walgreen Building Suite 2507
Evanston, IL 60201-1718
Phone
(847) 570-1316
Fax
(847) 570-2930
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2004028841 MO
Surgery Physician 208600000X 036.123221 IL Primary

Addresses

Primary practice location

2650 Ridge Ave
Walgreen Building Suite 2507
Evanston, IL 60201-1718

Mailing address

2650 Ridge Ave
Walgreen Building Suite 2507
Evanston, IL 60201-1718
Phone (847) 570-1316

Other identifiers 1

IdentifierTypeStateIssuer
207547605MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tmooyoung210314@direct.northshore.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20101006000461 IL Practitioner - General Surgery 3678527199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Chicago, Pritzker School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1300 Oak Ave
Evanston, IL 60201-4205
Phone (847) 869-1300

2650 Ridge Ave
Evanston, IL 60201-1700

757 Park Ave W
Highland Park, IL 60035-2558

777 Park Ave W
Highland Park, IL 60035-2433

9600 Gross Point Rd
Skokie, IL 60076-1214

Hospital & facility affiliations

  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.123221ILMDSurgery Physician
2004028841MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cook County Surgery CurrentSince Nov 23, 2010 Accepting new patients
Endeavor Health Medical Group Current Accepting new patients
Endeavor Health Medical Group CurrentSince Sep 27, 2010 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Nov 23, 2010 Accepting new patients
North County Emergency Physicians, LLP Past Accepting new patients
North County Emergency Physicians, LLP PastSince Jan 24, 2006 Accepting new patients

Locations

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

9532 Eagle Way
Chicago, IL 60678

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Rm 1223
Evanston, IL 60201
Phone (847) 570-1644

2650 Ridge Ave
Ste 2507
Evanston, IL 60201
Phone (847) 570-2461

757 Park Ave W
Ste 2850
Highland Park, IL 60035
Phone (847) 570-2512

757 Park Ave W
Highland Park, IL 60035
Phone (847) 480-3800

Organizations & group practices 7

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 4

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1215952650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "WALGREEN BUILDING SUITE 2507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1316",
            "fax_number": "847-570-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE",
            "address_2": "WALGREEN BUILDING SUITE 2507",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011718",
            "telephone_number": "847-570-1316",
            "fax_number": "847-570-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOO-YOUNG",
        "first_name": "TRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2004028841",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.123221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207547605",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmooyoung210314@direct.northshore.org",
            "affiliation": "N",
            "address_1": "2650 Ridge Ave",
            "address_2": "Walgreen Building Suite 2507",
            "city": "Evanston",
            "state": "IL",
            "country_code": "US",
            "postal_code": "602011718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.