Individual provider Active NPI

Jessica Lee Lambert Moore, O.D.

  • Optometrist
  • Anderson, IN
National Provider Identifier
1588004550
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18003931A Issued in IN
Practice address
5541 S Scatterfield Rd
Anderson, IN 46013-3140
Phone
(765) 748-0359
NPI assigned
Jul 4, 2013
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003931A IN Primary

Addresses

Primary practice location

5541 S Scatterfield Rd
Anderson, IN 46013-3140

Mailing address

11939 Redpoll TRL
Noblesville, IN 46060-5028
Phone (765) 748-0359

Other identifiers 2

IdentifierTypeStateIssuer
201333470MedicaidIN
0155691MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20151222001781 IN Practitioner - Optometry 9931320405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Optical Co IncGroup PAC ID 5597668574, 49 clinicians

Practice addresses (Care Compare)

5541 S Scatterfield Rd
Dr Tavel Family Eye Care
Anderson, IN 46013-3140
Phone (765) 644-3393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
City Optical Co., Inc. Optometrist Current Accepting new patients
City Optical Co., Inc. Optometrist CurrentSince Sep 29, 2023 Accepting new patients
City Optical Co., Inc. Optometrist CurrentSince Sep 29, 2023 Accepting new patients
Crosstown Eyecare LLC Optometrist PastSince Sep 1, 2021 Accepting new patients
City Optical Co., Inc. Optometrist Past Accepting new patients
City Optical Co., Inc. Optometrist Past Accepting new patients
Moody Eyes LLC Optometrist PastSince Sep 1, 2021 Accepting new patients
City Optical Co., Inc. Optometrist Past Accepting new patients
City Optical Co., Inc. Optometrist Past Accepting new patients
City Optical Co., Inc. Optometrist Past Accepting new patients

Locations

5541 S Scatterfield Rd
Anderson, IN 46013
Phone (765) 644-3393

2839 Lafayette Rd
Indianapolis, IN 46222
Phone (317) 924-1300

2835 Lafayette Rd
Indianapolis, IN 46222
Phone (317) 924-1300

519 S Memorial Dr
New Castle, IN 47362
Phone (765) 521-3400

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1372896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1588004550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11939 REDPOLL TRL",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460605028",
            "telephone_number": "765-748-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5541 S SCATTERFIELD RD",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460133140",
            "telephone_number": "765-748-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT MOORE",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-04",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003931A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201333470",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155691",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.