Patrick Devincent Moore, M.D.
Individual provider Active NPI Family Medicine Physician · Lafayette, LA
NPI 1982604419 · NPPES record last updated Oct 5, 2011
Key facts
- NPI
- 1982604419
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 024344 (LA)
- Practice address
- 3414 Moss St
Suite F&G
Lafayette, LA 70507-6107 - Phone
- (337) 706-8986
- Fax
- (337) 706-8714
- NPI assigned
- Jul 27, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Meharry Medical College School of Medicine, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
307 Alcide Dominique Dr
Lafayette, LA 70506-1052
Phone (337) 706-8986
Hospital & facility affiliations
- Our Lady of Lourdes Regional Medical Center, Inc
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031125000396 | LA | Practitioner - Family Practice | 0840194445 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024344 | LA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vermilion Emergency Group LLC | Current |
Accepting new patients | |
| PM Investments and Consulting, Inc. | Family Medicine | Current |
Accepting new patients |
| Louisiana Urgent Care LLC | Past |
Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| C & M Medical Services, Inc. | Past | Accepting new patients |
Locations
1310 W 7th St
Kaplan, LA 70548
Phone (318) 643-8300
3400 Moss St
Lafayette, LA 70507
3414 Moss St
Ste F
Lafayette, LA 70507
Phone (337) 534-0911
307 Alcide Dominique Dr
Lafayette, LA 70506
Phone (337) 706-8986
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/BBBGAA/Endpoint/BBBGAA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 024344 | LA | Yes |
Addresses
Primary practice location
3414 Moss St
Suite F&G
Lafayette, LA 70507-6107
Mailing address
PO Box 70
Carencro, LA 70520-0070
Phone (337) 706-8986
Other providers in Lafayette, LA
- Jennifer Moore
- Keyonna Chavontrel Moore
- Lacie Stafford Moore
- Mary Moore
- Matthew Moore
- Payton Anne Moore
- Shawntel Marie Moore
- Shelley Moore
- Taylor Moore
- Ellen Moosa
All providers in Lafayette, LA · Family Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.