Individual provider Active NPI

Charles A Moore, M.D.

  • Otolaryngology Physician
  • New Iberia, LA
National Provider Identifier
1417319807
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
327892 Issued in LA
Practice address
2308 E Main St Ste B
New Iberia, LA 70560-4029
Phone
(337) 369-3683
NPI assigned
Mar 24, 2016
Last updated
Mar 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 57.028402 OH
Otolaryngology Physician 207Y00000X 327892 LA Primary

Addresses

Primary practice location

2308 E Main St Ste B
New Iberia, LA 70560-4029

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone (854) 465-0799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20210830001719 LA Practitioner - Otolaryngology 0749574358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Cincinnati College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Ear, Nose, and Throat Specialists, Inc.Group PAC ID 0042313504, 65 clinicians
Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians

Practice addresses (Care Compare)

1516 Chemin Metairie Rd
Suite 1a
Youngsville, LA 70592-2000
Phone (337) 369-3683

2308 E Main St
Suite B
New Iberia, LA 70560-4029
Phone (985) 446-5079

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

604 N Acadia Rd
Suite 101
Thibodaux, LA 70301-4897
Phone 9854465079110

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Merit-based Incentive Payment System (MIPS)

Final score
96.05 of 100Reported as group
Quality
82.12
Promoting interoperability
100
Improvement activities
40
Cost
71.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
327892LAMDOtolaryngology Physician
57.028402OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Ear, Nose, & Throat Specialists, Inc. Otolaryngology CurrentSince Aug 1, 2021 Accepting new patients
Lsuhn Billing LLC CurrentSince Jul 1, 2022 Accepting new patients
Lsuhn Billing LLC CurrentSince Mar 17, 2024 Accepting new patients
Opal E Leblanc MD Apm LLC PastSince Oct 12, 2025 Accepting new patients

Locations

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

1231 Kenneth St
Morgan City, LA 70380
Phone (985) 384-9440

2308 E Main St
Ste B
New Iberia, LA 70560
Phone (337) 365-3541

604 N Acadia Rd
Ste 101
Thibodaux, LA 70301
Phone (985) 446-5079

1516 Chemin Metairie Rd
Ste 1A
Youngsville, LA 70592
Phone (337) 369-3683

Interoperability endpoints

  • Direct secure messaging: cmoore1774709@direct.ochsner.org

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1417319807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "854-465-0799",
            "fax_number": "985-447-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 E MAIN ST STE B",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604029",
            "telephone_number": "337-369-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-24",
        "last_updated": "2024-03-28",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "57.028402",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "327892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.