Individual provider Active NPI

Daniel Joseph Moore, MD

  • Pediatrics Physician
  • Baton Rouge, LA
National Provider Identifier
1699398172
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
336055 Issued in LA
Practice address
7373 Perkins Rd
Baton Rouge, LA 70808-4373
Phone
(225) 246-9790
Fax
(225) 246-9160
NPI assigned
May 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 336055 LA Primary

Addresses

Primary practice location

7373 Perkins Rd
Baton Rouge, LA 70808-4373

Mailing address

7373 Perkins Rd
Baton Rouge, LA 70808-4373
Phone (225) 246-9790

Other practice location 1

1200 Childrens Ave
Oklahoma City, OK 73104-4637
Phone (405) 271-4417

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230627001178 LA Practitioner - Pediatric Medicine 9931567716 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
336055LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation Pediatrics CurrentSince Jul 1, 2023 Accepting new patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Jul 1, 2023 Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

Interoperability endpoints

  • Direct secure messaging: dmoore5243294@direct.casso.us.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1589846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1699398172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084373",
            "telephone_number": "225-246-9790",
            "fax_number": "225-246-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084373",
            "telephone_number": "225-246-9790",
            "fax_number": "225-246-9160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Childrens Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731044637",
            "country_code": "US",
            "telephone_number": "405-271-4417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-19",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "336055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.