Mark S Moore, DO in Pueblo, CO - Medicare Radiology

Mark S Moore, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Pueblo, Colorado. His current practice location is 1008 Minnequa Ave, Pueblo, Colorado. You can reach out to his office (for appointments etc.) via phone at (719) 557-4000.

Mark S Moore is licensed to practice in Missouri (license number 112240) 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 1457465429.

Contact Information

	Mark S Moore, DO
	1008 Minnequa Ave, Pueblo, CO 81004-3733
	(719) 557-4000
	(970) 342-2093

Map and Direction

Physician's Profile

Full Name	Mark S Moore
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	1008 Minnequa Ave, Pueblo, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1457465429
Provider Enumeration Date: 08/18/2006
Last Update Date: 11/05/2020

Medicare PECOS Information:

PECOS PAC ID: 3274588850
Enrollment ID: I20061211000219

Medical Identifiers

Medical identifiers for Mark S Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1457465429	NPI	-	NPPES
100180650B	Other		OK CAID
100343220A	Other		KS CAID
83787844	Medicaid	CO
451258	Other		HLTLINK
115634	Other		MO BLUE
112240	Other	MO	MEDICAL LICENSE
248699902	Medicaid	MO

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	112240 (Missouri)	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. Mark S Moore allows following entities to bill medicare on his behalf.

Entity Name	Pueblo Radiological Group, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568444271 PECOS PAC ID: 5597661272 Enrollment ID: O20031211001035

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. Mark S 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
Mark S Moore, DO Po Box 7693, Loveland, CO 80537-0693 Ph: (970) 663-2742	Mark S Moore, DO 1008 Minnequa Ave, Pueblo, CO 81004-3733 Ph: (719) 557-4000

Reviews and Comments

Radiology Doctors in Pueblo, CO

Dr. Michael J Mccollum, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1008 Minnequa Ave, Pueblo, CO 81004 Phone: 719-542-7891
Krynn Louis Stegelmeier, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1619 N Greenwood St, Pueblo, CO 81003 Phone: 719-542-2167
Geoffrey Eric Johnson, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 1008 Minnequa Ave, Pueblo, CO 81004 Phone: 719-557-5460
Lisa T Cramer, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 1619 N Greenwood St, Suite 103, Pueblo, CO 81003 Phone: 719-542-2167 Fax: 719-542-0320
William J Bufkin, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 124 W Pitkin Ave, Pueblo, CO 81004 Phone: 719-584-7410 Fax: 719-542-7019
Dr. Anna-maria Alicia De Costa, MD, PHD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1008 Minnequa Ave, Pueblo, CO 81004 Phone: 719-557-5460 Fax: 719-557-4648
Gordon F Gibbs, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 115 E Riverwalk, Unit 200, Pueblo, CO 81003 Phone: 719-542-7891

Mark S Moore, DO - Medicare Radiology in Pueblo, CO