Timothy D Moore, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

106405 Issued in MO

Practice address

2630 Highway K
O Fallon, MO 63368-6624

Phone

(636) 240-5454

Fax

(636) 980-5335

NPI assigned

Jul 17, 2006

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Family Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Progress West Hospital Hospital, Ofallon, MO, CCN 260219
• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• Direct secure messaging: tmoore11267@direct.carenet.org

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Fairview Heights Medical Group SC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1679503668
  Medicare reassignment NPD
• Missouri Baptist Hospital of Sullivan

  • Critical Access Hospital
  • Sullivan, MO
  • NPI 1295743169

  Family Medicine

  Medicare reassignment NPD
• Fairview Heights Medical Group SC

  dba BJC Medical Group of Illinois

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1073022000
  NPD
• Missouri Baptist Hospital of Sullivan

  dba Sullivan Medical Office

  • Rural Health Clinic/Center
  • Sullivan, MO
  • NPI 1235228222
  NPD
• Physician Groups LC

  dba Medical Arts Clinic

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• North County Emergency Physicians, LLP

  • Emergency Medicine Physician
  • Florissant, MO
  • NPI 1356366934
  NPD (past)

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

• Barnes Jewish St Peters Hospital Inc

  dba Barnes-Jewish St Peters Hospital

  • General Acute Care Hospital
  • Saint Peters, MO
  • NPI 1144238908
  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• Progress West Healthcare Center

  • General Acute Care Hospital
  • O'Fallon, MO
  • NPI 1508938044
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1396762910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454",
            "fax_number": "636-980-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 HIGHWAY K",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686624",
            "telephone_number": "636-240-5454",
            "fax_number": "636-980-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIMOTHY",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-09-29",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "106405",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "106405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245208616",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396762910",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2630 Highway K",
            "city": "O Fallon",
            "state": "MO",
            "country_code": "US",
            "postal_code": "633686624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey P Moomey, RNFA
• Thomas Francis Mooney III, DDS, MDS
• Moore Transport of Ofallon LLC
• John Robert Moore, DC
• Lauren Rose Moore, M.S.
• Valentina J Moore, FNP-C
• William Moran
• Jamie Marie Moravec, PA-C
• Ehab Samir Morcos, MD
• Sydney Moreno, PLPC

• Family Medicine Physician in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.