Individual provider Active NPI

Marc R Moon, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Houston, TX
National Provider Identifier
1528086162
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
47499 Issued in TX
Practice address
6770 Bertner Ave
Houston, TX 77030-2604
Phone
(832) 355-3000
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 115539 MO
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 47499 TX Primary

Addresses

Primary practice location

6770 Bertner Ave
Houston, TX 77030-2604

Mailing address

One Baylor Plaza
Ms: Bcm390
Houston, TX 77030
Phone (832) 355-9910

Other practice location 1

THI Outpatient Clinic
1101 Bates Avenue
Houston, TX 77030
Phone (832) 355-9910

Other identifiers 1

IdentifierTypeStateIssuer
203784509MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211122002354 TX Practitioner - Cardiac SurgeryPractitioner - Thoracic Surgery 4082758248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac SurgeryAlso: Thoracic Surgery
Education
Wayne State University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8022243971, 1,230 clinicians

Practice addresses (Care Compare)

1327 Lake Pointe Pkwy
Sugar Land, TX 77478-4095
Phone (713) 637-7210

Hospital & facility affiliations

  • Baylor St Lukes Medical Center Hospital, Houston, TX, CCN 450193

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)25
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jan 3, 2022 Accepting new patients
Baylor College of Medicine CurrentSince Jan 3, 2022 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6770 Bertner Ave
Houston, TX 77030
Phone (832) 355-3000

1101 Bates Ave
Houston, TX 77030
Phone (713) 798-1300

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

1327 Lake Pointe Pkwy
Sugar Land, TX 77478
Phone (281) 566-1800

17450 St Lukes Way
Ste 340
The Woodlands, TX 77384
Phone (936) 266-2645

Organizations & group practices 3

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1528086162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE BAYLOR PLAZA",
            "address_2": "MS: BCM390",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "832-355-9910",
            "fax_number": "832-355-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 BERTNER AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302604",
            "telephone_number": "832-355-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "THI Outpatient Clinic",
            "address_2": "1101 Bates Avenue",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "832-355-9910",
            "fax_number": "832-355-9920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOON",
        "first_name": "MARC",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MO",
            "license": "115539",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "47499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203784509",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.