Maria Anne Moore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009-773 Issued in IL

Practice address

9500 S Western Ave
Ste G3A
Evergreen Park, IL 60805-2856

Phone

(708) 425-5285

NPI assigned

Nov 15, 2006

Last updated

Jun 25, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Maria Anne Gallagher Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luxottica of America Inc.

  • Point of Service
  • Mason, OH
  • NPI 1831244953

  IL

  Medicare reassignment
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1518030154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9225 S TRUMBULL AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608051534",
            "telephone_number": "312-307-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 S WESTERN AVE",
            "address_2": "STE G3A",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052856",
            "telephone_number": "708-425-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARIA",
        "middle_name": "ANNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009-773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "GALLAGHER",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nusaibah Mohsin
• Syed Mohsin, M.D.
• Wynnette J. Moneka, M.A.
• Patrick Montag
• Michael John Montesano, DO
• Markeita R. Moore, M.D.
• Taneisha Moore
• Elizabeth Morales, MS, CF-SLP
• Virginia Morgan, APRN, CNP
• Katherine Lynn Moriarty, OTR/L

• Optometrist in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.