Kenneth Lawrence Moore, M.D.

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

036-053328 Issued in IL

Practice address

12 Tartan Ridge Rd
Burr Ridge, IL 60527-8904

Phone

(630) 323-1316

NPI assigned

Sep 7, 2006

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

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

Neurology

Education

Chicago College of Medicine and Surgery, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Merit-based Incentive Payment System (MIPS)

Final score

93.28 of 100Reported as group

Quality

73.53

Promoting interoperability

100

Improvement activities

40

Cost

70.73

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmoore17314@uihealth.direct-ci.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.

• The Board of Trustees of the University of Illinois

  • Neurology Physician
  • Chicago, IL
  • NPI 1982824660
  Medicare reassignment Care Compare group NPD
• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)
• Morris Hospital

  • General Practice Physician
  • Channahon, IL
  • NPI 1275648511
  NPD (past)

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

• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1891899258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TARTAN RIDGE ROAD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278904",
            "telephone_number": "630-323-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 TARTAN RIDGE RD",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605278904",
            "telephone_number": "630-323-1316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KENNETH",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "IL",
            "license": "036-053328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Mitchell
• Atef Moawad, M.D.
• Saeid Mojtahedi, MD.
• Ryan J. Molis, D.D.S.
• Alicia Ann Moore, MS,OTRL
• Andrew Joseph Moormann, D.D.S.
• Morack Inc
• Shannon Marie Morrissey, LCPC
• Alexandra Morvai
• Mosaic Speech & Language Therapy PLLC

• Addiction Medicine (Psychiatry & Neurology) Physician in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.