NPIMap

Individual provider Active NPI

Evan Michael Moore, M.D.

  • Plastic Surgery Physician
  • Lexington, KY
National Provider Identifier
1902240559
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
52794 Issued in KY
Practice address
1401 Harrodsburg Rd Ste B75
Lexington, KY 40504-1724
Phone
(859) 276-3883
NPI assigned
Apr 25, 2013
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 52794 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd Ste B75
Lexington, KY 40504-1724

Mailing address

1401 Harrodsburg Rd Ste B75
Lexington, KY 40504-1724
Phone (859) 276-3883

Other identifiers 1

IdentifierTypeStateIssuer
7100324190MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200128001445 KY Practitioner - Plastic and Reconstructive Surgery 3375844913 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Kentucky College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Plastic Surgeons of Lexington, PLLCGroup PAC ID 1355318239, 3 clinicians

Practice addresses (Care Compare)

1401 Harrodsburg Rd
Suite B75
Lexington, KY 40504-1724
Phone (859) 276-3883

216 W Walnut St
Danville, KY 40422-1832

217 S 3Rd St
Danville, KY 40422-1823
Phone (859) 239-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.64 of 100Reported as group
Quality
56.63
Improvement activities
40
Cost
74.98

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy19
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ephraim McDowell Health Resource, Inc CurrentSince Sep 1, 2023 Accepting new patients
St Claire Medical Center, Inc CurrentSince Apr 24, 2020 Accepting new patients
Ephraim McDowell Health Resource, Inc. Current Accepting new patients
St Claire Medical Center, Inc Plastic Surgery CurrentSince Apr 24, 2020 Accepting new patients
Ephraim McDowell Health Resource,Inc CurrentSince Sep 1, 2023 Accepting new patients
St Claire Medical Center, Inc., Plastic Surgery Current Accepting new patients

Locations

130 Daniel Dr
Danville, KY 40422
Phone (606) 236-2222

216 W Walnut St
Ste A
Danville, KY 40422
Phone (859) 239-5870

222 Medical Cir
Morehead, KY 40351
Phone (606) 783-6455

425 Clinic Dr
Morehead, KY 40351
Phone (606) 784-1049

555 W Sun St
Morehead, KY 40351
Phone (606) 207-2931

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1366848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1902240559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE B75",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041724",
            "telephone_number": "859-276-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE B75",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405041724",
            "telephone_number": "859-276-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EVAN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-25",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "KY",
            "license": "52794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100324190",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.