Jacob Robert Moore, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

125066516 Issued in IL

Practice address

5841 S Maryland Ave RM L539
Chicago, IL 60637-1447

Phone

(773) 702-9500

NPI assigned

Jun 14, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 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

Specialty

Emergency Medicine

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aurora Emergency Physicians LLCGroup PAC ID 1850657180, 44 clinicians

Riverside Emergency Physicians LLCGroup PAC ID 6204294119, 35 clinicians

Clarksville Emergency Group PCGroup PAC ID 6507277423, 149 clinicians

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Riverside Medical Center Hospital, Kankakee, IL, CCN 140186
• Franciscan Health Michigan City Hospital, Michigan City, IN, CCN 150015
• Morrison Community Hospital Hospital, Morrison, IL, CCN 141329
• Advocate Illinois Masonic Medical Center Hospital, Chicago, IL, CCN 140182
• Rush Oak Park Hospital Hospital, Oak Park, IL, CCN 140063

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmoore144138@direct.rush.rush-health.com
• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
• Direct secure messaging: jmoore414217@direct.myadvocateaurora.org

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.

• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Yorkville, IL
  • NPI 1407379423
  Medicare reassignment Care Compare group NPD
• Riverside Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Kankakee, IL
  • NPI 1548969181
  Medicare reassignment Care Compare group NPD
• Rush University Medical Group

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• Clarksville Emergency Group, PC

  • Emergency Medicine Physician
  • Corydon, IN
  • NPI 1023487154
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Rush Oak Park ER Physicians Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Oak Park, IL
  • NPI 1447260880
  Medicare reassignment NPD
• Jacob R Moore MD SC

  • Emergency Care Clinic/Center
  • Morrison, IL
  • NPI 1144097254
  NPD Authorized official
• Advocate Health & Hospitals Corporation

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Aurora Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Aurora, IL
  • NPI 1508389628
  NPD
• Morrison Community Hospital District

  • Critical Access Hospital
  • Morrison, IL
  • NPI 1184844938
  NPD
• Rush University Medical Center

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1184269425
  NPD

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

• Advocate North Side Health Network

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1912014564
  Care Compare affiliation
• Morrison Community Hospital District

  • Critical Access Hospital
  • Morrison, IL
  • NPI 1184844938
  Care Compare affiliation
• Riverside Medical Center

  • General Acute Care Hospital
  • Kankakee, IL
  • NPI 1538208210
  Care Compare affiliation
• Rush Oak Park Hospital Inc

  • General Acute Care Hospital
  • Oak Park, IL
  • NPI 1558391706
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1679336747
  Care Compare affiliation
• Franciscan Health Michigan City

  • General Acute Care Hospital
  • Michigan City, IN
  • NPI 1710051941
  Care Compare affiliation

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434240000000",
    "number": "1750762928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 14TH ST APT 803",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053666",
            "telephone_number": "815-988-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE RM L539",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2015-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125066516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Moore
• Grace Elizabeth Moore, DDS
• Hannah Moore
• Helene Darlak Moore, PSY.D.
• Henry Dunbar Moore, D.D.S.
• Janaan Schmuhl Moore, AU.D.
• Janine Moore, LPC
• Jayla Ariel Moore, B.S
• Jennifer Adele Moore, LCPC
• Jennifer L Moore, PT, MPT, NCS

• Emergency Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2015; 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.