Benjamin J. Moody, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

12407597-1205 Issued in UT

Practice address

30 N 1900 E # 1C026
Salt Lake City, UT 84132-0002

Phone

(801) 581-2417

NPI assigned

Mar 28, 2020

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 WY

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

Specialty

Emergency Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwest Emergency Physicians LLCGroup PAC ID 3476462334, 267 clinicians

Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

North Lincoln County Hospital DistrictGroup PAC ID 4789580218, shared by 4 NPIs, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Star Valley Medical Center Hospital, Afton, WY, CCN 531313
• Sagewest Health Care Hospital, Riverton, WY, CCN 530008
• St Johns Medical Center Hospital, Jackson, WY, CCN 530015

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northwest Emergency Physicians LLC

  dba Nep

  • Emergency Medicine Physician
  • Arlington, WA
  • NPI 1235172370

  WY

  Medicare reassignment Care Compare group NPD
• Teton County Hospital District

  dba St John's Health

  • General Practice Physician
  • Jackson, WY
  • NPI 1487818605
  Medicare reassignment Care Compare group NPD (past)
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment NPD
• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment NPD

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

• North Lincoln County Hospital District

  dba Star Valley Medical Center

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Care Compare affiliation
• Riverton Memorial Hospital LLC

  dba SageWest Health Care

  • Rural Acute Care Hospital
  • Lander, WY
  • NPI 1245337286
  Care Compare affiliation
• Teton County Hospital District

  dba St John's Medical Center/ or St John's Health

  • General Acute Care Hospital
  • Jackson, WY
  • NPI 1801835475
  Care Compare affiliation

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1528696358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E # 1C026",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "BENJAMIN",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "12407597-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael James Monument, MD
• Marisol Z. Monzon, MD
• Alastair E. Moody, MD
• Anna Moody
• Asher Moody
• Catriona Moody, MD
• Justin Moody, DDS
• Brian Mooers, M.D.
• Frederick B Mooers, MD
• Mary Gretchen Mooers, MD

• Emergency Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.