Kenneth Taedo Moon, MD - Medicare Family Medicine in Hollywood, MD

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Kenneth Taedo Moon, MD is a medicare enrolled "Family Medicine" physician in Hollywood, Maryland. His current practice location is 24435 Mervell Dean Rd, Hollywood, Maryland. You can reach out to his office (for appointments etc.) via phone at (301) 373-2116.

Kenneth Taedo Moon is licensed to practice in Maryland (license number D0057219) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1972591345.

Contact Information

Kenneth Taedo Moon, MD
24435 Mervell Dean Rd,
Hollywood, MD 20636-2712
(301) 373-2116
Not Available

Map and Direction




Physician's Profile

Full NameKenneth Taedo Moon
GenderMale
SpecialityFamily Medicine
Location24435 Mervell Dean Rd, Hollywood, Maryland
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1972591345
  • Provider Enumeration Date: 10/11/2005
  • Last Update Date: 09/02/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 2264620947
  • Enrollment ID: I20101222000135

Medical Identifiers

Medical identifiers for Kenneth Taedo Moon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972591345NPI-NPPES
080185963OtherDCMEDICARE RR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 32929 (District Of Columbia)Secondary
207Q00000XFamily Medicine D0057219 (Maryland)Primary

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. Kenneth Taedo Moon allows following entities to bill medicare on his behalf.
Entity NameMgmc Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891797148
PECOS PAC ID: 9537073119
Enrollment ID: O20031220000056
Entity NameDrynachan Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891044657
PECOS PAC ID: 2264718824
Enrollment ID: O20170413001277
Entity NameSignify Health Medical Associates Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20200115000070

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. Kenneth Taedo Moon 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 AddressPractice Location Address
Kenneth Taedo Moon, MD
Po Box 37,
Hollywood, MD 20636-0037

Ph: (301) 373-2116		Kenneth Taedo Moon, MD
24435 Mervell Dean Rd,
Hollywood, MD 20636-2712

Ph: (301) 373-2116

Reviews and Comments


Family Medicine Doctors in Hollywood, MD

John L Bennett, MD
Family Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 24035 Three Notch Rd, Hollywood, MD 20636
Phone: 301-373-7900    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.