Active NPI
Jared L Moon, DPM
- Podiatrist
- Crown Point, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 99053018A
- Practice address
- 10607 Randolph St
Crown Point, IN 46307-7504 - Phone
- (262) 366-7994
- NPI assigned
- Mar 28, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | POD001156 | GA | |
| Podiatrist | 213E00000X | 99053018A | IN | Primary |
Addresses
Primary practice location
10607 Randolph St
Crown Point, IN 46307-7504
Mailing address
10607 Randolph St
Crown Point, IN 46307-7504
Phone (262) 366-7994
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1500 S Lake Park Ave
Hobart, IN 46342-6638
9130 Columbia Ave
Munster, IN 46321-2932
Hospital & facility affiliations
- Powers Home Health Services
- St Mary Medical Center Inc
- St Catherine Hospital Inc
- Community Hospital
- Powers Health Rehabilitation Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 236 |
| Removal of nail tissue | 22 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| POD001156 | GA | MD | Podiatrist |
| 99053018A | IN | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Network Inc | Current | Accepting new patients |
Locations
1500 S Lake Park Ave
#402
Hobart, IN 46342
Phone (219) 945-4488
1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551
9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166
Interoperability endpoints
- jmoon38974@ssdirect.comhs.org
Organizations & group practices 1
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.
-
- Family Medicine Physician
- St John, IN
- NPI 1457610487
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital
- Crown Point, IN
- NPI 1801301437
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Munster, IN
- NPI 1003918210
-
- General Acute Care Hospital
- East Chicago, IN
- NPI 1689776882
-
- Home Health Agency
- Hobart, IN
- NPI 1528160736
-
- General Acute Care Hospital
- Hobart, IN
- NPI 1558463745
-
- General Acute Care Hospital
- Hobart, IN
- NPI 1962504175
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345161600000",
"number": "1649546284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10607 RANDOLPH ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463077504",
"telephone_number": "262-366-7994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10607 RANDOLPH ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463077504",
"telephone_number": "262-366-7994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOON",
"first_name": "JARED",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-28",
"last_updated": "2012-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "GA",
"license": "POD001156",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "99053018A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Crown Point, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2012; 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.