Individual provider Active NPI

Joseph Patrick Moore, MD

  • Gastroenterology Physician
  • Colorado Springs, CO
National Provider Identifier
1972607067
Registry record updated Oct 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
37170 Issued in CO
Practice address
2222 North Nevada Avenue
Suite 5001
Colorado Springs, CO 80907-6865
Phone
(719) 636-1201
Fax
(719) 636-1326
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 37170 CO Primary

Addresses

Primary practice location

2222 North Nevada Avenue
Suite 5001
Colorado Springs, CO 80907-6865

Mailing address

2920 N Cascade Ave
Ste 301
Colorado Springs, CO 80907-6265
Phone (719) 636-1201

Other identifiers 2

IdentifierTypeStateIssuer
607324OtherCOBCBS
01371707MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20110119000208 CO Practitioner - GastroenterologyPractitioner - Internal Medicine 7214022706 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37170COMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Portercare Adventist Health System CurrentSince Mar 15, 2014 Accepting new patients
Salida Hospital District CurrentSince Dec 1, 2018 Accepting new patients
Portercare Adventist Health System Current Accepting new patients
Portercare Adventist Health System CurrentSince Mar 15, 2014 Accepting new patients
Trinidad Area Health Association CurrentSince Nov 1, 2018 Accepting new patients
Salida Hospital District CurrentSince Dec 1, 2018 Accepting new patients
Trinidad Area Health Association CurrentSince Nov 1, 2018 Accepting new patients

Locations

2352 Meadows Blvd
Ste 300
Castle Rock, CO 80109
Phone (303) 744-1961

7750 S Broadway
Ste 260
Littleton, CO 80122
Phone (303) 734-8650

1000 Rush Dr
Salida, CO 81201
Phone (719) 530-2265

410 Benedicta Ave
Trinidad, CO 81082
Phone (719) 846-8051

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1972607067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 N CASCADE AVE",
            "address_2": "STE 301",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076265",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 NORTH NEVADA AVENUE",
            "address_2": "SUITE 5001",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076865",
            "telephone_number": "719-636-1201",
            "fax_number": "719-636-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOSEPH",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CO",
            "license": "37170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "607324",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01371707",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.