Jason L Moore, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

39945 Issued in IA

Practice address

45 10TH St W
Saint Paul, MN 55102-1062

Phone

(651) 232-3000

NPI assigned

Mar 28, 2006

Last updated

Nov 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

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

Specialty

Emergency Medicine

Education

Medical College of Ohio, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Iowa Emergency Services LLCGroup PAC ID 3678837580, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercyone Clinton Medical Center Hospital, Clinton, IA, CCN 160080

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoore3934919@direct.trinity-health.org

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.

• Iowa Emergency Services LLC

  • Emergency Medicine Physician
  • Clinton, IA
  • NPI 1821591454
  Medicare reassignment Care Compare group NPD
• CCM Health

  • Critical Access Hospital
  • Montevideo, MN
  • NPI 1720086028
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center-Clinton, Inc

  dba MercyOne Clinton Medical Center

  • General Acute Care Hospital
  • Clinton, IA
  • NPI 1427093962
  Care Compare affiliation

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1720049109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27400 FRANKLIN RD",
            "address_2": "#B707",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 10TH ST W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021062",
            "telephone_number": "651-232-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1925 Woodwinds Dr",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551254445",
            "country_code": "US",
            "telephone_number": "651-232-0100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6071 W Outer Dr",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482352624",
            "country_code": "US",
            "telephone_number": "313-966-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1575 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091126",
            "country_code": "US",
            "telephone_number": "651-232-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JASON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "61613",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301080458",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "39945",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MI",
            "license": "4301080458",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MI",
            "identifier": "JM080458",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104785416",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104785425",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104715823",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler James Moon, MD
• Shannon Marie Mooney, CNP
• Moore Family Eyecare PLLC
• Candis Moore
• Courtney Jean Moore, APRN, CNM
• Jennifer Moore
• John Lewis Moore Jr.
• Lanora Moore, RN, LSN
• Steven Robert Moore, M.D.
• Zonita Moore

• Emergency Medicine Physician in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Emergency Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.

Verify at the official NPI Registry.