Mary Kathleen Moore, D.O.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

3976 Issued in OK

Practice address

100 S Bliss Ave
Tahlequah, OK 74464-2512

Phone

(918) 458-3104

Fax

(918) 458-3580

NPI assigned

Jul 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 TX, OK2 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

Oklahoma State University College of Osteopathic Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeastern Health System Hospital, Tahlequah, OK, CCN 370089
• Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Merit-based Incentive Payment System (MIPS)

Final score

90.91 of 100Reported as apm

Quality

76.55

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

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.

• Northeastern Health System

  • Emergency Medicine Physician
  • Tahlequah, OK
  • NPI 1457574170
  Medicare reassignment Care Compare group NPD
• Adair County Health Center, Inc.

  dba Memorial Hospital

  • Medical Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1972780765
  Medicare reassignment NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Adair County Health Center, Inc.

  dba Memorial Hospital

  • Rural Acute Care Hospital
  • Stilwell, OK
  • NPI 1790753358
  NPD
• Adair County Health Center,Inc.

  dba Physicians Clinic

  • Family Medicine Physician
  • Stilwell, OK
  • NPI 1326017492
  NPD
• Cherokee Nation

  dba Cherokee Nation Public Health

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Salina, OK
  • NPI 1326054081
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Vinita, OK
  • NPI 1558377226
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Nowata, OK
  • NPI 1891703716
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Stilwell, OK
  • NPI 1992711345
  NPD

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

• Cherokee Nation

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1275799645
  Care Compare affiliation
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Claremore, OK
  • NPI 1497568968

  Hospital

  Care Compare affiliation
• Northeastern Health System

  dba Tahlequah City Hospital

  • General Acute Care Hospital
  • Tahlequah, OK
  • NPI 1003865999
  Care Compare affiliation
• Northeastern Health System

  dba Fort Gibson Medical Clinic

  • Rural Health Clinic/Center
  • Fort Gibson, OK
  • NPI 1013458652

  Hospital

  Care Compare affiliation
• Northeastern Health System

  dba Tahlequah Medical Group Primary Care

  • Rural Health Clinic/Center
  • Tahlequah, OK
  • NPI 1306387949

  Hospital

  Care Compare affiliation
• Northeastern Health System

  • Addiction (Substance Use Disorder) Counselor
  • Tahlequah, OK
  • NPI 1689338519

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902837776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 675",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744650675",
            "telephone_number": "918-458-5583",
            "fax_number": "918-458-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642512",
            "telephone_number": "918-458-3104",
            "fax_number": "918-458-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OK",
            "license": "3976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moore Imbibition LLC
• Celeste Moore
• David Franklin Moore III, PHARM.D.
• Lauren Moore, DPT
• Lynna J Moore
• Michael M Moore, DPT
• Nikieshia Patrice Moore
• Seth Garrett Moore
• Angel Javier Morales, M.D.
• Danielle Morgan

• Emergency Medical Services (Emergency Medicine) Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.