Melissa Justine Moore, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52784 Issued in KY

Practice address

1500 James Simpson Jr Way
Covington, KY 41011

Phone

(859) 655-4111

Fax

(859) 655-4815

NPI assigned

Jun 15, 2016

Last updated

May 9, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Family Practice

Education

Ohio State University College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Elizabeth Home Care Home health agency, Florence, KY, CCN 187075
• Amedisys Home Health of Kentucky Home health agency, Crestview Hills, KY, CCN 187179
• St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
• St Elizabeth Florence Hospital, Florence, KY, CCN 180045
• St Elizabeth Ft Thomas Hospital, Fort Thomas, KY, CCN 180001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmauntel292151@direct-prd.stelizabeth.com

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.

• Summit Medical Group, Inc

  dba St. Elizabeth Physicians

  • Family Medicine Physician
  • Erlanger, KY
  • NPI 1750343216
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, Inc.

  dba St. Elizabeth Physicians

  • Foot & Ankle Surgery Podiatrist
  • Crestview Hills, KY
  • NPI 1043188378
  NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  Family Medicine

  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  NPD (past)

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

• Amedisys SP-Oh, L.L.C.

  dba Amedisys Home Health of Kentucky

  • Home Health Agency
  • Crestview Hills, KY
  • NPI 1215940093
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  dba St Elizabeth Florence

  • General Acute Care Hospital
  • Florence, KY
  • NPI 1154365062
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  • General Acute Care Hospital
  • Edgewood, KY
  • NPI 1467492421
  Care Compare affiliation
• St Elizabeth Medical Center, Inc

  dba St Elizabeth Ft. Thomas

  • General Acute Care Hospital
  • Fort Thomas, KY
  • NPI 1740221795
  Care Compare affiliation
• St. Elizabeth Home Care Services, LLC

  dba St. Elizabeth Home Care

  • Home Health Agency
  • Florence, KY
  • NPI 1316136534
  Care Compare affiliation

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1568812014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-655-4111",
            "fax_number": "859-655-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 JAMES SIMPSON JR WAY",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "41011",
            "telephone_number": "859-655-4111",
            "fax_number": "859-655-4815"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 James Simpson Jr Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "41011",
            "country_code": "US",
            "telephone_number": "859-655-4111",
            "fax_number": "859-655-4815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MELISSA",
        "middle_name": "JUSTINE",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116029002",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "52784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deaira Mitchell
• Zachary Mockbee, MSW, LCSW
• Molecular Diagnostics Laboratories Inc
• Molecular Diagnostics Laboratories Inc
• Connor D Mook, MS, MA, LPCC
• Thomas J Moore, OD
• Vanessa Moore, LPCA
• Christopher Morandi, LPCC-S
• Alessandra Morejon
• Donna Ruth Moreland, LCSW

• Family Medicine Physician in Covington, KY
• Providers in Covington, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.