Active NPI
Thomas J Moon Jr., M.D.
- Pediatric Cardiology Physician
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- ME113107
- Practice address
- 1600 SW Archer Rd
Gainesville, FL 32610-3003 - Phone
- (352) 627-9350
- Fax
- (352) 273-9054
- NPI assigned
- Apr 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | ME113107 | FL | Primary |
| Pediatrics Physician | 208000000X | ME113107 | FL | |
| Pediatric Cardiology Physician | 2080P0202X | DR47006 | CO |
Addresses
Primary practice location
1600 SW Archer Rd
Gainesville, FL 32610-3003
Mailing address
PO Box 746645
Atlanta, GA 30374-6645
Phone (904) 202-2092
Other practice location 1
3025 Shrine Rd Ste 350
Brunswick, GA 31520-4786
Phone (904) 202-8550
Other practice location 2
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Phone (904) 202-8550
Other practice location 3
1747 Baptist Clay Dr Ste 100
Fleming Island, FL 32003-8503
Phone (904) 202-8550
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005915000 | Medicaid | FL | |
| 14KY8 | Other | FL | BCBS |
| 003125542A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1443 San Marco Blvd
Jacksonville, FL 32207-8535
Phone (904) 633-4110
841 Prudential Dr
Suite 100
Jacksonville, FL 32207-8346
Phone (904) 633-4110
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DR47006 | CO | MD | Pediatric Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Specialty Physicians Inc | Pediatric Cardiology | Current | Accepting new patients |
| Baptist Specialty Physicians Inc | Pediatric Cardiology | Current | Accepting new patients |
| University of Florida Jacksonville Physicians Inc | Pediatrics | Current | Accepting new patients |
Locations
1219 Dunn Ave
Daytona Beach, FL 32114
Phone (386) 255-4568
1747 Baptist Clay Dr
Ste 100
Fleming Island, FL 32003
Phone (904) 202-8550
1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110
841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290
836 Prudential Dr
Ste 802
Jacksonville, FL 32207
Phone (904) 202-8290
841 Prudential Dr
Ste 100
Jacksonville, FL 32207
Phone (904) 633-4110
3650 NW Devane St
Lake City, FL 32055
Phone (386) 755-1221
1747 Baptist Clay Dr
Orange Park, FL 32003
Phone (904) 202-8550
2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861
3025 Shrine Rd
Ste 350
Brunswick, GA 31520
Phone (904) 202-8550
Interoperability endpoints
- tmoon73077@direct.shands.ufl.edu
Organizations & group practices 5
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1982821799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746645",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746645",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-627-9350",
"fax_number": "352-273-9054"
}
],
"practiceLocations": [
{
"address_1": "3025 Shrine Rd Ste 350",
"address_purpose": "LOCATION",
"city": "Brunswick",
"state": "GA",
"postal_code": "315204786",
"country_code": "US",
"telephone_number": "904-202-8550",
"fax_number": "904-393-7808",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "841 Prudential Dr Ste 280",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322078350",
"country_code": "US",
"telephone_number": "904-202-8550",
"fax_number": "904-393-7808",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1747 Baptist Clay Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Fleming Island",
"state": "FL",
"postal_code": "320038503",
"country_code": "US",
"telephone_number": "904-202-8550",
"fax_number": "904-393-7808",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOON",
"first_name": "THOMAS",
"middle_name": "J",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-20",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "FL",
"license": "ME113107",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME113107",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "CO",
"license": "DR47006",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005915000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "14KY8",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003125542A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.