NPIMap

Individual provider Active NPI

Andrew Jacob Moore, M.D.

  • Hematology & Oncology Physician
  • Cape Girardeau, MO
National Provider Identifier
1881813202
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2009003017 Issued in MO
Practice address
789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387
Phone
(573) 519-4830
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2009003017 MO Primary

Addresses

Primary practice location

789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387

Mailing address

789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387
Phone (573) 519-4830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091022000113 MO Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology 0042357147 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Hematology, Internal Medicine
Education
University of Missouri, Kansas City, School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians
Missouri Delta Medical CenterGroup PAC ID 1355252891, 134 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

1126 N Main St
Sikeston, MO 63801-5046
Phone (573) 471-4312

1200 N One Mile Rd
Suite a
Dexter, MO 63841-1013
Phone (573) 624-5566

1701 Lacey St
Cape Girardeau, MO 63701-5230
Phone (573) 334-4822

789 S Mount Auburn Rd
Cape Girardeau, MO 63703-6387
Phone (573) 519-4830

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Hospital Current Accepting new patients
Missouri Delta Medical Center CurrentSince May 1, 2024 Accepting new patients
Missouri Delta Medical Center CurrentSince May 1, 2024 Accepting new patients
Southeast Missouri Hospital Physicians, LLC Hematology & Oncology CurrentSince Aug 10, 2013 Accepting new patients

Locations

789 S Mount Auburn Rd
Cape Girardeau, MO 63703
Phone (573) 519-4800

1701 Lacey St
Cpe Girardeau, MO 63701
Phone (573) 334-4822

1200 N One Mile Rd
Ste A
Dexter, MO 63841
Phone (573) 624-5566

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

1126 N Main St
Sikeston, MO 63801
Phone (573) 471-4312

Ownership & related parties

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
Mercy Hospital SoutheastCape Girardeau, MO, CCN 260110 Hospital Corporate Director Jan 1, 2024
Mercy Hospital SoutheastCape Girardeau, MO, CCN 26T110 Hospital Corporate Director Aug 1, 2025
Mercy HospiceCape Girardeau, MO, CCN 261537 Hospice Corporate Director Jan 1, 2024
Mercy Southeast Primary Care WestCape Girardeau, MO, CCN 268657 Rural health clinic Corporate Director Jan 1, 2024
Mercy Southeast PediatricsCape Girardeau, MO, CCN 268674 Rural health clinic Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 5

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

Organizations & group practices 5

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1881813202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036387",
            "telephone_number": "573-519-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 S MOUNT AUBURN RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036387",
            "telephone_number": "573-519-4830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MO",
            "license": "2009003017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.