Jacqueline Diana Moore, MD is a medicare enrolled "Surgery" physician in Aldie, Virginia. She graduated from medical school in 2007 and has 17 years of diverse experience with area of expertise as Vascular Surgery. She is a member of the group practice Privia Medical Group Llc, Centra Medical Group Llc and her current practice location is
24560 Southpoint Dr, Aldie, Virginia. You can reach out to her office (for appointments etc.) via phone at
(703) 258-0399.
Jacqueline Diana Moore is licensed to practice in Virginia (license number 0101270338) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1619173838.
Physician's Profile
Full Name | Jacqueline Diana Moore |
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Gender | Female |
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Speciality | Vascular Surgery |
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Experience | 17 Years |
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Location | 24560 Southpoint Dr, Aldie, Virginia |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Jacqueline Diana Moore graduated from medical school in 2007
NPI Data:
- NPI Number: 1619173838
- Provider Enumeration Date: 06/25/2007
- Last Update Date: 10/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 5395073670
- Enrollment ID: I20200825000723
Medical Identifiers
Medical identifiers for Jacqueline Diana Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619173838 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | S2120 (Texas) | Secondary |
208600000X | Surgery | 0101270338 (Virginia) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Privia Medical Group Llc | 4385682061 | 1223 |
Centra Medical Group Llc | 4789606088 | 636 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jacqueline Diana Moore allows following entities to bill medicare on her behalf.
Entity Name | Sentara Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265485270 PECOS PAC ID: 8921903923 Enrollment ID: O20031203000466 |
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Entity Name | Centra Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1649228966 PECOS PAC ID: 4789606088 Enrollment ID: O20051230000147 |
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Entity Name | Privia Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140603000011 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Diana Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacqueline Diana Moore, MD 24560 Southpoint Dr, Aldie, VA 20105-3510 Ph: (703) 258-0399 | Jacqueline Diana Moore, MD 24560 Southpoint Dr, Aldie, VA 20105-3510 Ph: (703) 258-0399 |
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