Active NPI
Johanna Catherine Moore, M.D.
- Emergency Medicine Physician
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 52841
- Practice address
- 701 Park Ave South
Hennepin County Medical Center Revenue Management
Minneapolis, MN 55415 - Phone
- (612) 873-3044
- Fax
- (612) 630-8242
- NPI assigned
- May 12, 2008
- Last updated
- Oct 19, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 52841 | MN | Primary |
Addresses
Primary practice location
701 Park Ave South
Hennepin County Medical Center Revenue Management
Minneapolis, MN 55415
Mailing address
701 Park Ave South
Hennepin County Medical Center Revenue Management
Minneapolis, MN 55415
Phone (612) 873-3044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366619108 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Minnesota Medical School, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 92.67 of 100
- Quality
- 74.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.86
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52841 | MN | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hennepin Healthcare System, Inc | Current | Accepting new patients | |
| Hennepin Healthcare System Inc | Current | Accepting new patients | |
| Hennepin Healthcare System, Inc | Current | Accepting new patients |
Locations
701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005
701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334
914 S 8th St
#D4
Minneapolis, MN 55404
Phone (612) 347-6450
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Hennepin County Medical Center
- Rehabilitation Hospital Unit
- Minneapolis, MN
- NPI 1033138136
-
dba HCMC Specialty Services Pharmacy
- Specialty Pharmacy
- Minneapolis, MN
- NPI 1619567625
-
dba Hennepin County Medical Center
- Clinic/Center
- Minneapolis, MN
- NPI 1710313895
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Hennepin County Medical Center
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1407897309
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287446400000",
"number": "1366619108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 PARK AVE SOUTH",
"address_2": "HENNEPIN COUNTY MEDICAL CENTER REVENUE MANAGEMENT",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55415",
"telephone_number": "612-873-3044",
"fax_number": "612-630-8242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 PARK AVE SOUTH",
"address_2": "HENNEPIN COUNTY MEDICAL CENTER REVENUE MANAGEMENT",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55415",
"telephone_number": "612-873-3044",
"fax_number": "612-630-8242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JOHANNA",
"middle_name": "CATHERINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2010-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MN",
"license": "52841",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1366619108",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.