Tim J Moore, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

MD2008-0111 Issued in NM

Practice address

1329 Gusdorf Rd
Taos, NM 87571

Phone

(575) 758-5001

Fax

(575) 737-5046

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Taos Health Systems Inc Holy Cross Hospital

  • General Acute Care Hospital
  • Taos, NM
  • NPI 1194751958

  Corporate Director

  CMS ownership
• Taos Health Systems, Inc., Holy Cross Hospital

  • Critical Access Hospital
  • Taos, NM
  • NPI 1902338049

  Corporate Director

  CMS ownership

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.

• Taos Professional Services,LLC

  • Surgery Physician
  • Taos, NM
  • NPI 1891070777

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Taos Professional Services, LLC

  • General Practice Physician
  • Taos, NM
  • NPI 1235597964
  NPD
• Moms LLC

  • Medical Specialty Clinic/Center
  • Taos, NM
  • NPI 1053458240
  NPD (past)
• Taos Health Systems Inc Holy Cross

  • Internal Medicine Physician
  • Taos, NM
  • NPI 1639310436
  NPD (past)
• Berkshire Faculty Services Inc

  • Multi-Specialty Clinic/Center
  • Pittsfield, MA
  • NPI 1548212939
  NPD (past)
• Fairview Hospital

  • Rural Health Clinic/Center
  • Great Barrington, MA
  • NPI 1881252286
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328227200000",
    "number": "1730147497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 GUSDORF RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-5001",
            "fax_number": "575-737-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 GUSDORF RD",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "575-758-5001",
            "fax_number": "575-737-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TIM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "MD2008-0111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3125165",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60122838",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mycca S. Montoya, LMFT
• Yvette Montoya, LPCC
• Jeremy Mooneyham
• Hope Marie Moore, LMSW
• Jannette A Moore
• Brian Moraga
• Janelli Morales
• Gail Frances Moran, MSW
• Megan E Morgan
• Morning Light Physical Therapy Inc

• Obstetrics & Gynecology Physician in Taos, NM
• Providers in Taos, NM by specialty
• Obstetrics & Gynecology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.