Individual provider Active NPI

Derek Moore, MD, MPH

  • Transplant Surgery Physician
  • Nashville, TN
National Provider Identifier
1376697391
Registry record updated Dec 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transplant Surgery PhysicianTaxonomy code 204F00000X
License
36541 Issued in TN
Practice address
4230 Harding Pike Ste 530
Nashville, TN 37205-2094
Phone
(615) 222-4060
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Transplant Surgery Physician 204F00000X 36541 TN Primary
Surgery Physician 208600000X 36541 TN
Surgery Physician 208600000X MD428381 PA

Addresses

Primary practice location

4230 Harding Pike Ste 530
Nashville, TN 37205-2094

Mailing address

300 20TH Ave N Ste 403
Nashville, TN 37203-5180
Phone (615) 222-6618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20080723000775 TN Practitioner - General Surgery 9335212372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Vanderbilt University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

4220 Harding Pike
Nashville, TN 37205-2005
Phone (615) 222-6977

Hospital & facility affiliations

  • Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD428381PAMDSurgery Physician
36541TNMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Apr 1, 2017 Accepting new patients
Saint Thomas West Hospital Past Accepting new patients

Locations

4220 Harding Pike
Ste 401
Nashville, TN 37205
Phone (615) 222-6618

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

300 20th Ave N
Fl 9
Nashville, TN 37203

4230 Harding Pike
Ste 530
Nashville, TN 37205
Phone (615) 222-5500

Interoperability endpoints

  • Direct secure messaging: derek.moore.1@7654.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1376697391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 20TH AVE N STE 403",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035180",
            "telephone_number": "615-222-6618",
            "fax_number": "615-222-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE STE 530",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052094",
            "telephone_number": "615-222-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEREK",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204F00000X",
            "taxonomy_group": "",
            "desc": "Transplant Surgery",
            "state": "TN",
            "license": "36541",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "36541",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD428381",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.