Individual provider Active NPI

Patrick Daniel Moore, DPM

  • Podiatrist
  • Kearney, NE
National Provider Identifier
1558321505
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
265 Issued in NE
Practice address
3811 29TH Ave
Ste3
Kearney, NE 68845-1280
Phone
(308) 237-2621
Fax
(308) 237-2023
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 265 NE Primary

Addresses

Primary practice location

3811 29TH Ave
Ste3
Kearney, NE 68845-1280

Mailing address

3811 29TH Ave
Ste 3
Kearney, NE 68845-1280
Phone (308) 237-2621

Other identifiers 2

IdentifierTypeStateIssuer
480028579OtherPALMETTO GBA-RRMC
47082440100MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050105000935 NE Practitioner - Podiatry 9739137860 Practice locations: Kearney, NE
O20100930059545 NE DME Supplier - Physician - Podiatry 2264480391 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kearney, NE

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3811 29TH Ave
Suite 3
Kearney, NE 68845-1280
Phone (308) 237-2621

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
95.09
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Daniel Moore Moore Foot Clinic Podiatrist CurrentSince Apr 10, 2013 Accepting new patients
Kearney Foot Clinic PC Podiatrist Past Accepting new patients

Locations

3811 29th Ave
Ste 3
Kearney, NE 68845
Phone (308) 237-2621

Interoperability endpoints

  • Direct secure messaging: patrickmoore@534.securemail.prognocis.com

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 2

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1558321505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 29TH AVE",
            "address_2": "STE 3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688451280",
            "telephone_number": "308-237-2621",
            "fax_number": "308-237-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 29TH AVE",
            "address_2": "STE3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688451280",
            "telephone_number": "308-237-2621",
            "fax_number": "308-237-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PATRICK",
        "middle_name": "DANIEL",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RRMC",
            "identifier": "480028579",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47082440100",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.