Benjamin J Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2508 Issued in NE

Practice address

4920 S 30TH St Ste 103
Omaha, NE 68107-1656

Phone

(402) 734-4110

Fax

(402) 734-3990

NPI assigned

Mar 24, 2020

Last updated

Aug 19, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

All Care Health CenterGroup PAC ID 0547241390, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bmoore680018@direct.ochin.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.

• All Care Health Center

  • Federally Qualified Health Center (FQHC)
  • Council Bluffs, IA
  • NPI 1114906906
  Medicare reassignment Care Compare group
• Oneworld Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bellevue, NE
  • NPI 1295105112
  NPD
• Oneworld Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1982553186
  NPD
• All Care Health Center

  • Community/Retail Pharmacy
  • Council Bluffs, IA
  • NPI 1124461363
  NPD (past)

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

• Alegent Health Bergan Mercy Health System

  dba CHI Health Mercy Council Bluffs

  • General Acute Care Hospital
  • Council Bluffs, IA
  • NPI 1265517759
  Care Compare affiliation

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1447887096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 S 30TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 S 9th St # 219",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681083678",
            "country_code": "US",
            "telephone_number": "515-271-1569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BENJAMIN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alayzia Moore
• Anna Moore
• Aryanna Moore
• Aubreyona Moore
• Becky Leann Moore, LCSW
• Bridget L. Moore, CRNA
• Bridget Marie Moore
• Brittany Moore
• Brooke Moore
• Brooklynn Moore

• Physician Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.