Michael Shane Moore Jr., DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

6031 Issued in OK

Practice address

744 W 9TH St
Tulsa, OK 74127-9020

Phone

(918) 599-1000

NPI assigned

Jun 19, 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 OK

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

Anesthesiology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Utb Anesthesia PLLCGroup PAC ID 0547448524, 23 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oklahoma State University Medical Center Hospital, Tulsa, OK, CCN 370078
• Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmoore86396@direct.saintfrancis.com

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.

• Utb Anesthesia PLLC

  • Anesthesiology Physician
  • Tulsa, OK
  • NPI 1407150709
  Medicare reassignment Care Compare group
• Hospital Care Consultants Region II Inc

  • Internal Medicine Physician
  • West Memphis, AR
  • NPI 1558491449

  OK

  Medicare reassignment NPD
• Northstar Anesthesia of Oklahoma, PLLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1043516628

  OK

  Medicare reassignment NPD

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

• Oklahoma State University Medical Trust

  dba Oklahoma State University Medical Center

  • General Acute Care Hospital
  • Tulsa, OK
  • NPI 1578704938
  Care Compare affiliation
• Saint Francis Hospital Muskogee Inc

  dba Saint Francis Hospital Muskogee

  • General Acute Care Hospital
  • Muskogee, OK
  • NPI 1386188837
  Care Compare affiliation

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1871975425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W 9TH ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279020",
            "telephone_number": "918-599-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6161 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361902",
            "country_code": "US",
            "telephone_number": "918-494-0612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "6031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Opal Moore, LPC
• Melandy Moore, M.S.
• Melissa L Moore, DPT
• Meloney Ellen Moore
• Micaylon Moore
• Natalie Nicole Moore, M.S. CCC-SLP
• Odetta Maria Moore, LPC
• Payton Cheyanne Moore
• Quanah Moore
• Rebecca Nichole Moore, APRN-CNP

• Anesthesiology Physician in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Anesthesiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.