Individual provider Active NPI

Ben Moore, M.D.

  • Emergency Medicine Physician
  • Kingsville, TX
National Provider Identifier
1649297276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
D1743 Issued in TX
Practice address
1311 General Cavazos Blvd
Kingsville, TX 78363-7129
Phone
(361) 595-1661
NPI assigned
Jul 17, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D1743 TX Primary

Addresses

Primary practice location

1311 General Cavazos Blvd
Kingsville, TX 78363-7129

Mailing address

352 Bobby Clark Dr
Canyon Lake, TX 78133-2124
Phone (210) 494-1786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D1743TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC Past Accepting new patients
Bayside Emergency Pyhsicians, LLP Emergency Medicine Past Accepting new patients
Bayside Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Bayside Emergency Physicians, LLP Emergency Medicine Past Accepting new patients
Abk Emergency Physicians PLLC Emergency Medicine Past Accepting new patients

Organizations & group practices 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649297276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 BOBBY CLARK DR",
            "city": "CANYON LAKE",
            "state": "TX",
            "postal_code": "781332124",
            "telephone_number": "210-494-1786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 GENERAL CAVAZOS BLVD",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783637129",
            "telephone_number": "361-595-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "D1743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.