Mindy Stutzman Moore, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009756 Issued in IL

Practice address

1920 Nerge Rd
Elk Grove Village, IL 60007-2972

Phone

(954) 835-2835

NPI assigned

Oct 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Post-Acute Medical Services 1 PCGroup PAC ID 6305112103, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Illinois Post-Acute Medical Services 1 PC

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1952830853
  Medicare reassignment Care Compare group NPD
• CS Pacs 3 Il, S.C.

  • Hospitalist Physician
  • Park Ridge, IL
  • NPI 1598577124
  Medicare reassignment NPD
• CS Pacs 3 Midwest LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1972368785

  IL

  Medicare reassignment NPD
• NV Pacs 2 LLC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1427534809

  IL

  Medicare reassignment NPD
• Illinois Behavioral Health Group, P.C.

  • Clinical Psychologist
  • Skokie, IL
  • NPI 1881392678
  NPD
• Mi Pacs 2 PC

  • Hospitalist Physician
  • Northville, MI
  • NPI 1205418357
  NPD (past)

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1356744593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235A N CLYBOURN AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 NERGE RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600072972",
            "telephone_number": "954-835-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MINDY",
        "middle_name": "STUTZMAN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-02",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deisy Molina Cortes
• Wendy Moncada, MSW
• Monikris Inc.
• Bruce J Montella, M.D.
• Alvaro Montoya, MD
• Janeth Morales Blanco
• Phillip M Moreau, APN
• Nadia R Moreno, RBT
• Mary K Morrell, M.D.
• James M Moss, MD

• Clinical Psychologist in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.