Mark K Moore, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

J9911 Issued in TX

Practice address

601 W Hwy 6
101
Waco, TX 76710-5575

Phone

(254) 772-5454

Fax

(254) 772-6464

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Southwestern Medical School at Dallas, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.moore.1@9635.direct.athenahealth.com

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.

• Providence Health Alliance

  • Specialist
  • Waco, TX
  • NPI 1932210838
  Medicare reassignment Care Compare group NPD
• Providence Health Alliance

  • Rural Health Clinic/Center
  • Waco, TX
  • NPI 1336590462
  NPD
• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1255445458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18962",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "800-566-5050",
            "fax_number": "254-537-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W HWY 6",
            "address_2": "101",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767105575",
            "telephone_number": "254-772-5454",
            "fax_number": "254-772-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARK",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J9911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037091803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dod David Moore, D.D.S.
• Jacob Gordon Moore, DDS
• James Walter Moore, LPC
• Joseph Scott Moore, MS, ATC
• Macasiana Ashanti Moore
• Nickie Michelle Moore
• Rachel Moore, D.C.
• Shane Moore
• Micah Bonnett Mordecai, D.C.
• Espiridion Moreno Jr., LMSW

• Obstetrics & Gynecology Physician in Waco, TX
• Providers in Waco, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.

Verify at the official NPI Registry.