NPIMap

Individual provider Active NPI

Jeffrey Moore, MD

  • Orthopaedic Surgery of the Spine Physician
  • Oklahoma City, OK
National Provider Identifier
1932515475
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
36986 Issued in OK
Practice address
3130 SW 89TH St Ste 200
Oklahoma City, OK 73159-7909
Phone
(888) 957-7463
NPI assigned
Jul 4, 2014
Last updated
Sep 30, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X MD467707 PA
Orthopaedic Surgery of the Spine Physician 207XS0117X 36986 OK Primary

Addresses

Primary practice location

3130 SW 89TH St Ste 200
Oklahoma City, OK 73159-7909

Mailing address

3705 NW 63Rd St Ste 201
Oklahoma City, OK 73116-1937
Phone (405) 297-4968

Other practice location 1

3705 NW 63rd St Ste 201
Oklahoma City, OK 73116-1937
Phone (405) 297-4968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20200917001662 OK Practitioner - Orthopedic Surgery 6800122391 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sho Professional Services LLCGroup PAC ID 7810366051, 4 clinicians

Practice addresses (Care Compare)

100 SE 59TH St
Oklahoma City, OK 73129-3616
Phone (888) 957-7463

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion47
Laminectomy or laminotomy (partial removal of spine bones)22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD467707PAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Vascular and Embolization Center by Flex Medical Group CurrentSince Jul 1, 2025 Accepting new patients
The Physicians Group LLC CurrentSince Sep 1, 2020 Accepting new patients
Jeffrey Moore MD PLLC Orthopaedic Surgery of the Spine CurrentSince Nov 18, 2024 Accepting new patients
Sho Professional Services LLC Orthopaedic Surgery of the Spine CurrentSince Sep 6, 2022 Accepting new patients
Surgical Hospital of Oklahoma LLC Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients
Norman Regional Hospital Authority Past Accepting new patients

Locations

1616 S Kelly Ave
Edmond, OK 73013
Phone (405) 330-0015

100 SE 59th St
Oklahoma City, OK 73129
Phone (405) 364-9789

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

1145 W I 240 Service Rd
Ste F100
Oklahoma City, OK 73139
Phone (405) 898-9048

3130 SW 89th St
Ste 200
Oklahoma City, OK 73159
Phone (405) 645-5475

3705 NW 63rd St
Ste 201
Oklahoma City, OK 73116
Phone (405) 673-3280

8324 S Walker Ave
Oklahoma City, OK 73139
Phone (405) 473-6866

4409 N Kickapoo Ave
Shawnee, OK 74804
Phone (405) 242-4100

Organizations & group practices 8

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 6

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": "1404432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1932515475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 NW 63RD ST STE 201",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161937",
            "telephone_number": "405-297-4968",
            "fax_number": "972-848-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SW 89TH ST STE 200",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731597909",
            "telephone_number": "888-957-7463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 NW 63rd St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731161937",
            "country_code": "US",
            "telephone_number": "405-297-4968",
            "fax_number": "972-848-5269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-04",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "PA",
            "license": "MD467707",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OK",
            "license": "36986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.