Individual provider Active NPI

Aaron Moore, MD

  • Urology Physician
  • Springfield, IL
National Provider Identifier
1699137794
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036.167755 Issued in IL
Practice address
301 N 8TH St Ste 3B
Springfield, IL 62701-1041
Phone
(217) 545-7123
Fax
(217) 545-7305
NPI assigned
Mar 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 65701 TN
Urology Physician 208800000X 036.167755 IL Primary

Addresses

Primary practice location

301 N 8TH St Ste 3B
Springfield, IL 62701-1041

Mailing address

PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000

Other practice location 1

747 N Rutledge St Fl 5
Springfield, IL 62702-6700
Phone (217) 545-8000

Other practice location 2

610 N Westgate Ave
Jacksonville, IL 62650-1152
Phone (217) 545-8000

Other identifiers 2

IdentifierTypeStateIssuer
036167755MedicaidIL
Q074833MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220512001739 TN Practitioner - Urology 4587959424 Reassigns benefits to 1 organization
I20240201002115 IL Practitioner - Urology 4587959424 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Southern Illinois University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

747 N Rutledge St
Springfield, IL 62702-6700
Phone (217) 545-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
40.99 of 100Reported as group
Quality
58.34
Promoting interoperability
0
Improvement activities
0
Cost
78.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65701TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Apr 1, 2024 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Apr 1, 2024 Accepting new patients
St Johns Hospital of the Hospital Sisters of the Third Order of St F CurrentSince Apr 1, 2024 Accepting new patients
Cookeville Regional Medical Group, Inc CurrentSince May 6, 2022 Accepting new patients
St Johns Hospital of the Hospital Sisters of the Third Order of St F CurrentSince Apr 1, 2024 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

610 N Westgate Ave
Jacksonville, IL 62650
Phone (217) 243-8455

515 N College St
Lowr
Lincoln, IL 62656

800 E Carpenter St
Springfield, IL 62702
Phone (217) 525-5643

301 N 8th St
Ste 3B
Springfield, IL 62701
Phone (217) 545-7123

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

747 N Rutledge St
Springfield, IL 62702
Phone (217) 545-6112

201 E Madison St
Ste 328
Springfield, IL 62702

747 N Rutledge St
Fl 5
Springfield, IL 62702
Phone (217) 545-3262

100 W 4th St
Ste 350
Cookeville, TN 38501
Phone (931) 646-2901

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

320 N Oak Ave
Cookeville, TN 38501
Phone (931) 528-5547

Interoperability endpoints

  • Direct secure messaging: aaronmoore@siusm.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/10383/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 5

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": "1459123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1699137794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19639",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949639",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST STE 3B",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-7123",
            "fax_number": "217-545-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 N Rutledge St Fl 5",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627026700",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "610 N Westgate Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "626501152",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-243-7951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AARON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-28",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "65701",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036.167755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036167755",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q074833",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.