Individual provider Active NPI

Marcus Moody, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Hoover, AL
National Provider Identifier
1497794945
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
27114 Issued in AL
Practice address
2116 Data Park
Hoover, AL 35244-1203
Phone
(205) 733-9595
Fax
(205) 733-9599
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 27114 AL Primary

Addresses

Primary practice location

2116 Data Park
Hoover, AL 35244-1203

Mailing address

2116 Data Park
Hoover, AL 35244-1203
Phone (205) 733-9595

Other identifiers 1

IdentifierTypeStateIssuer
150987MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20061103000399 AL Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 5294732244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Vanderbilt University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hoover Ear, Nose and Throat Associates, P.C.Group PAC ID 0840217139, 3 clinicians

Practice addresses (Care Compare)

2116 Data Park
Hoover, AL 35244-1203
Phone (205) 733-9595

Hospital & facility affiliations

  • Princeton Baptist Medical Center Hospital, Birmingham, AL, CCN 010103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27114ALMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoover Ear, Nose & Throat Associates, P.C. CurrentSince Oct 7, 2013 Accepting new patients
Rousso Facial Plastic Surgery Clinic PC PastSince Jul 1, 2012 Accepting new patients

Organizations & group practices 2

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 1

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1497794945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 DATA PARK",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352441203",
            "telephone_number": "205-733-9595",
            "fax_number": "205-733-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 DATA PARK",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352441203",
            "telephone_number": "205-733-9595",
            "fax_number": "205-733-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "AL",
            "license": "27114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150987",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

Verify at the official NPI Registry.