Individual provider Active NPI

Jaime Megan Moore, M.D.

  • Pediatric Obesity Medicine Physician
  • Aurora, CO
National Provider Identifier
1386934362
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Obesity Medicine PhysicianTaxonomy code 2080B0002X
License
DR.0055059 Issued in CO
Practice address
13123 E 16TH Ave
Children'S Hospital Colorado- Dept of Nutrition
Aurora, CO 80045-7106
Phone
(720) 777-1234
NPI assigned
Apr 12, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Obesity Medicine Physician 2080B0002X DR.0055059 CO Primary
Internal Medicine Physician 207R00000X DR.0055059 CO
Pediatrics Physician 208000000X DR.0055059 CO

Addresses

Primary practice location

13123 E 16TH Ave
Children'S Hospital Colorado- Dept of Nutrition
Aurora, CO 80045-7106

Mailing address

PO Box 110429
Aurora, CO 80042-0429
Phone (303) 493-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150908002271 CO Practitioner - Pediatric Medicine 1850532656 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0055059COMDPediatric Obesity Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated Internal Medicine CurrentSince Aug 1, 2015 Accepting new patients
Children'S Hospital Colorado Current Accepting new patients
University Physicians, Incorporated CurrentSince Aug 1, 2015 Accepting new patients

Locations

13123 E 16th Ave
Ste B130
Aurora, CO 80045

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

4090 Briargate Pkwy
Colorado Springs, CO 80920
Phone (719) 305-1234

8111 E Lowry Blvd
Ste 120
Denver, CO 80230
Phone (720) 810-5442

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: jmoore54891@direct.childrenscolorado.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1386934362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429",
            "telephone_number": "303-493-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13123 E 16TH AVE",
            "address_2": "CHILDREN'S HOSPITAL COLORADO- DEPT OF NUTRITION",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457106",
            "telephone_number": "720-777-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAIME",
        "middle_name": "MEGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-12",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080B0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Obesity Medicine",
            "state": "CO",
            "license": "DR.0055059",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0055059",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0055059",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.