Moataz M Gaddor, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

036153985 Issued in IL

Practice address

222 S Woods Mill Rd
Chesterfield, MO 63017-3625

Phone

(314) 205-6050

Fax

(314) 434-5939

NPI assigned

Jun 20, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL, AR, WY, MO, IA5 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 5

Specialty

Internal MedicineAlso: Critical Care (Intensivists)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Iowa Hospital CorporationGroup PAC ID 0749198026, 139 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Lukes Regional Medical Center Hospital, Sioux City, IA, CCN 160146

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgaddor730168@direct.baptist-healthar.org

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.

• Northwest Iowa Hospital Corporation

  dba St. Luke's Regional Medical Center

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sioux City, IA
  • NPI 1215962550
  Medicare reassignment Care Compare group NPD
• Mercy Clinic Joplin LLC

  • Family Medicine Physician
  • Joplin, MO
  • NPI 1215264817

  Internal Medicine

  Medicare reassignment NPD
• Banner Hospital Based Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Casper, WY
  • NPI 1619464120
  Medicare reassignment NPD
• Baptist Health Services

  dba Baptist Health Foot and Ankle Clinic-Fort Smith

  • Foot & Ankle Surgery Podiatrist
  • Fort Smith, AR
  • NPI 1922587690
  Medicare reassignment NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Family Medicine Physician
  • Carol Stream, IL
  • NPI 1033149844

  Internal Medicine

  Medicare reassignment NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Elgin, IL
  • NPI 1821641499
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Banner Hospital Based Physicians West LLC

  • Multi-Specialty Clinic/Center
  • Ogallala, NE
  • NPI 1144025446
  NPD
• Baptist Health Services

  • Family Medicine Physician
  • Fort Smith, AR
  • NPI 1750856043

  Internal Medicine

  NPD
• Central Dupage Physician Group

  dba Northwestern Medicine Regional Medical Group

  • Orthopaedic Surgery Physician
  • Geneva, IL
  • NPI 1780012344
  NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Kankakee, IL
  • NPI 1174320873
  NPD
• Cep America Illinois Intensivists

  • Critical Care Medicine (Internal Medicine) Physician
  • Effingham, IL
  • NPI 1538661475
  NPD

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

• Northwest Iowa Hospital Corporation

  dba St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Sioux City, IA
  • NPI 1962594622
  Care Compare affiliation

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1255694600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-205-6050",
            "fax_number": "314-434-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-205-6050",
            "fax_number": "314-434-5939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 N Rockton Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611033655",
            "country_code": "US",
            "telephone_number": "815-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GADDOR",
        "first_name": "MOATAZ",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-20",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2012017419",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036153985",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IL",
            "license": "036153985",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IL",
            "license": "036153985",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IL",
            "license": "036153985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255694600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Fry, L.P.C.
• Full Circle Home Care Missouri, LLC
• Michael Carl Fusco, M.D.
• FV at Home - Home Health, LLC (Friendship Village Home Health)
• G Patrick O'Donnell M.D.
• Monica Gainer
• Nicole L. Gaines, MSW, LCSW
• Madhuri Gali, MD
• David A Galli, M.D.
• Kahdijah C Gandy

• Critical Care Medicine (Internal Medicine) Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Critical Care Medicine (Internal Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.