Individual provider Active NPI

John David Moore, MD

  • Anesthesiology Physician
  • Saint Louis, MO
National Provider Identifier
1396731774
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
110519 Issued in MO
Practice address
3015 N Ballas Rd
Dept Anesthesiology
Saint Louis, MO 63131-2329
Phone
(800) 862-9980
Fax
(314) 362-1185
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 110519 MO Primary

Addresses

Primary practice location

3015 N Ballas Rd
Dept Anesthesiology
Saint Louis, MO 63131-2329

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (800) 862-9980

Other identifiers 1

IdentifierTypeStateIssuer
204739510MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040813000883 MO Practitioner - AnesthesiologyPractitioner - Interventional Pain ManagementPractitioner - Pain Management 3375516834 Reassigns benefits to 3 organizations
I20070619000399 IL Practitioner - AnesthesiologyPractitioner - Pain Management 3375516834 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians
Western Anesthesiology Associates IncGroup PAC ID 6204720667, 251 clinicians

Practice addresses (Care Compare)

3015 N Ballas Rd
Dept of Anesthesiology
St Louis, MO 63131-2329
Phone (314) 996-5000

901 E 5TH St
Deptartment of Anesthesiology
Washington, MO 63090-3127
Phone (636) 239-4100

Hospital & facility affiliations

  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Mercy Hospital Washington Hospital, Washington, MO, CCN 260052

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Anesthesia Providers S.C Anesthesiology CurrentSince Sep 6, 2016 Accepting new patients
Midwest Anesthesia Associates, P.C. CurrentSince Mar 5, 2019 Accepting new patients
Western Anesthesiology Associates, Inc. Anesthesiology CurrentSince Oct 2, 2018 Accepting new patients
Washington University CurrentSince Mar 1, 2020 Accepting new patients
Washington University CurrentSince Mar 1, 2020 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
Mid-Missouri Anesthesia Consultants PC Anesthesiology PastSince Jul 1, 1996 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

2 Memorial Dr
Alton, IL 62002
Phone (618) 462-0710

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

15945 Clayton Rd
Ste 220CLAY
Ballwin, MO 63011
Phone (636) 239-8097

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

3015 N Ballas Rd
Saint Louis, MO 63131
Phone (314) 996-5330

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

1 Barnes Hsp Plz
Saint Louis, MO 63110
Phone (314) 273-4966

660 S Euclid Ave
#8054
Saint Louis, MO 63110
Phone (314) 286-1045

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Ste 108
Washington, MO 63090
Phone (636) 390-1715

Interoperability endpoints

  • Direct secure messaging: jmoore135567@direct.carenet.org
  • Direct secure messaging: jmoore91060@directc.mercy.net

Organizations & group practices 7

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 2

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": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1396731774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 N BALLAS RD",
            "address_2": "DEPT ANESTHESIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312329",
            "telephone_number": "800-862-9980",
            "fax_number": "314-362-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "110519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204739510",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "3015 N Ballas Rd",
            "address_2": "Dept Anesthesiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.