Dominic Moore, M.D.

Primary specialty

Pediatric Hospice and Palliative Medicine PhysicianTaxonomy code 2080H0002X

License

8598327-1205 Issued in UT

Practice address

100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103

Phone

(801) 662-3645

NPI assigned

Sep 28, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Pediatric Medicine

Education

State University of Ny Upstate Medical University, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Utah Pediatric Acuity CareGroup PAC ID 6406148345, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• SCL Front Range Home Health, LLC

  dba Intermountain Health Homecare - Denver

  • Home Health Agency
  • Denver, CO
  • NPI 1609863984

  Corporate Director

  CMS ownership

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.

• University of Utah Pediatric Acuity Care

  • Pediatric Critical Care Medicine Physician
  • Salt Lake City, UT
  • NPI 1619325131

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• University of Utah Pediatric Services

  dba Department of Pediatrics

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1487018974
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Northern Utah KidsCare

  • Pediatrics Physician
  • Ogden, UT
  • NPI 1609906650
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah Pediatric Acuity Care

  dba Pediatric Emergency Medicine

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Salt Lake City, UT
  • NPI 1538523675
  NPD
• University of Utah Pediatric Acuity Care

  dba University of Utah Pediatric Palliative Care

  • Pediatric Hospice and Palliative Medicine Physician
  • Salt Lake City, UT
  • NPI 1851898365
  NPD
• University of Utah Pediatric Services

  dba Pediatric Plastic Surgery

  • Plastic Surgery Physician
  • Salt Lake City, UT
  • NPI 1144684994
  NPD
• University of Utah Pediatric Services

  dba Pediatric Infectious Disease

  • Pediatric Infectious Diseases Physician
  • Salt Lake City, UT
  • NPI 1285098855
  NPD

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1265766026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-3645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARIO CAPECCHI DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-662-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DOMINIC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-28",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "8598327-1205",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "UT",
            "license": "8598327-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoore273992@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cyndie M Moore, CPSS CM
• David A Moore, MD
• David Earl Moore, MD
• Davis Scott Moore, PHARMD
• Dean Tyler Moore
• Evan Corlee Moore, M.D.
• Haley Moore
• Hannah Elaine Moore, MD
• Heidi Moore
• Ian Michael Moore

• Pediatric Hospice and Palliative Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatric Hospice and Palliative Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.