Individual provider Active NPI

Nicholas J.E. Moore, MD

  • Diagnostic Radiology Physician
  • Colorado Springs, CO
National Provider Identifier
1417905092
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
48664 Issued in CO
Practice address
1390 Kelly Johnson Blvd
Colorado Springs, CO 80920-3908
Phone
(719) 593-1799
NPI assigned
May 5, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 48664 CO Primary

Addresses

Primary practice location

1390 Kelly Johnson Blvd
Colorado Springs, CO 80920-3908

Mailing address

1390 Kelly Johnson Blvd
Colorado Springs, CO 80920-3908
Phone (719) 593-1799

Other identifiers 1

IdentifierTypeStateIssuer
88639266OtherCOMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NY, WV, KY4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20100629000311 CO Practitioner - Diagnostic Radiology 5597701573 Reassigns benefits to 8 organizations
I20240620001882 NY Practitioner - Diagnostic Radiology 5597701573 Reassigns benefits to 2 organizations
I20250321000466 WV Practitioner - Diagnostic Radiology 5597701573 Reassigns benefits to 4 organizations
I20250715000551 KY Practitioner - Diagnostic Radiology 5597701573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health AssociationGroup PAC ID 1759291313, 69 clinicians
Louisville Radiology Imaging Consultants PLLCGroup PAC ID 2264436120, 103 clinicians
Adi Radiology PCGroup PAC ID 7911236427, 153 clinicians
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians
Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

122 Pinnell St
Ripley, WV 25271-9101
Phone (304) 372-2731

1407 Mesa Ave
Colorado Springs, CO 80906-3118
Phone (708) 915-5671

2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 264-1000

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

670 Bills Ranch Rd
Apt 329E
Frisco, CO 80443-5213
Phone (615) 315-0600

911 Bypass Rd
BLDG a
Pikeville, KY 41501-1689
Phone (606) 430-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.1 of 100Reported as group
Quality
76.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
75.32
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
85
Improvement activities
40
Cost
76.83

Merit-based Incentive Payment System (MIPS)

Final score
86.23 of 100Reported as group
Quality
83.8
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
328236NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Imaging Center LLC Diagnostic Radiology CurrentSince May 23, 2025 Accepting new patients
Adi Radiology PC Diagnostic Radiology CurrentSince Apr 27, 2025 Accepting new patients
Community Health Association CurrentSince Apr 25, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jun 26, 2025 Accepting new patients
West Virginia University Medical Corporation Diagnostic Radiology CurrentSince Jun 26, 2025 Accepting new patients
Crouse Radiology Associates LLP Diagnostic Radiology CurrentSince Jun 1, 2024 Accepting new patients
Pikeville Medical Center Inc. CurrentSince Jun 11, 2025 Accepting new patients
Medical Imaging Center LLP CurrentSince Jun 1, 2024 Accepting new patients
Louisville Radiology Imaging Consultants, PLLC Diagnostic Radiology CurrentSince Jul 10, 2025 Accepting new patients
Community Health Association CurrentSince Apr 25, 2025 Accepting new patients
Syracuse Orthopedic Specialists, PLLC CurrentSince Jul 5, 2024 Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Oct 15, 2025 Accepting new patients
Middle Tennessee Imaging LLC Diagnostic Radiology CurrentSince Jun 15, 2025 Accepting new patients
Radiology Alliance PC Diagnostic Radiology CurrentSince Mar 3, 2025 Accepting new patients
THS Physician Partners Inc CurrentSince Feb 1, 2025 Accepting new patients
Pikeville Medical Center Inc CurrentSince Jun 11, 2025 Accepting new patients
North Country Hospital & Health Center Inc Diagnostic Radiology Past Accepting new patients
Community Health Association Past Accepting new patients
Visiting Nurse Association of Wisconsin, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Penrad Imaging LLC PastSince Nov 8, 2020 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients
Great Lakes Radiologists SC Diagnostic Radiology Past Accepting new patients
Penrad Imaging LLC PastSince Nov 8, 2020 Accepting new patients
Penrad Imaging LLC PastSince May 17, 2020 Accepting new patients

Locations (25 of 31)

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

295 Main St
Calhoun, KY 42327
Phone (270) 273-9310

140 Veterans Memorial Ave
Clay, KY 42404
Phone (270) 326-4780

107 E Main St
Earlington, KY 42410
Phone (270) 383-2521

44 W Main St
Fordsville, KY 42343
Phone (270) 276-3150

440 Hopkinsville St
Greenville, KY 42345
Phone (270) 338-8000

1211 Old Main St
Hartford, KY 42347
Phone (270) 298-3806

20 E McMurtry Ave
Hartford, KY 42347
Phone (270) 504-1300

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

210 N Main St
Morgantown, KY 42261
Phone (270) 526-3137

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2200 E Parrish Ave
Bldg D
Owensboro, KY 42303
Phone (270) 688-1770

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

215 E Main St
Providence, KY 42450
Phone (270) 667-7017

1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011

37 W Garden St
Ste 107
Auburn, NY 13021
Phone (315) 255-2828

5700 W Genesee St
Ste 7
Camillus, NY 13031
Phone (315) 701-1670

5000 Brittonfield Pkwy
Ste A112
East Syracuse, NY 13057
Phone (315) 234-4680

5719 Widewaters Pkwy
Syracuse, NY 13214
Phone (315) 251-3110

736 Irving Ave
Syracuse, NY 13210
Phone (315) 470-7111

739 Irving Ave
Ste 150
Syracuse, NY 13210
Phone (315) 470-2985

L3539
Columbus, OH 43260
Phone (304) 414-4800

3310 Aspen Grove Dr
Ste 203
Franklin, TN 37067
Phone (615) 771-8274

12554 Riata Vista Cir
Fl 1
Austin, TX 78727

Organizations & group practices 26

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.

View all 26

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417905092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203908",
            "telephone_number": "719-593-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 KELLY JOHNSON BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203908",
            "telephone_number": "719-593-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICHOLAS",
        "middle_name": "J.E.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "48664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "88639266",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.