Mark Benton Moore, ARNP in Charlotte, NC - Medicare Nurse Practitioner

Mark Benton Moore, ARNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Charlotte, North Carolina. His current practice location is 1000 Blythe Blvd, Charlotte, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 355-4772.

Mark Benton Moore is licensed to practice in North Carolina (license number 9700154) 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 1205948981.

Contact Information

	Mark Benton Moore, ARNP
	1000 Blythe Blvd, Charlotte, NC 28203-5812
	(704) 355-4772
	(704) 355-6227

Map and Direction

Provider's Profile

Full Name	Mark Benton Moore
Gender	Male
Speciality	Nurse Practitioner - Pediatrics
Location	1000 Blythe Blvd, Charlotte, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205948981
Provider Enumeration Date: 08/31/2006
Last Update Date: 12/06/2021

Medicare PECOS Information:

PECOS PAC ID: 1658466602
Enrollment ID: I20140616001953

Medical Identifiers

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

Identifier	Type	State	Issuer
1205948981	NPI	-	NPPES
NP1153	Medicaid	SC
7005122	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	9700154 (North Carolina)	Primary
363L00000X	Nurse Practitioner	18527 (Tennessee)	Secondary
363LP0200X	Nurse Practitioner - Pediatrics	ARNP 9219935 (Florida)	Secondary

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 Benton Moore allows following entities to bill medicare on his behalf.

Entity Name	Southeastern Emergency Services P C
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669414264 PECOS PAC ID: 6204730195 Enrollment ID: O20031121000687

Entity Name	Southeastern Emergency Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997

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 Benton 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 Benton Moore, ARNP Po Box 601372, Charlotte, NC 28260-1372 Ph: (704) 355-4772	Mark Benton Moore, ARNP 1000 Blythe Blvd, Charlotte, NC 28203-5812 Ph: (704) 355-4772

Reviews and Comments

Nurse Practitioner Nurses in Charlotte, NC

Melissa E Jesse, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2236 Shenandoah Ave, Charlotte, NC 28205 Phone: 704-999-9857
Mrs. Adrienne Dunlap Lane, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Hawthorne Ln, Charlotte, NC 28204 Phone: 704-384-4109
Melissa Renee Flood, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1225 Harding Pl, Ste 5100, Charlotte, NC 28204 Phone: 704-355-8850
Anna Philbeck Burgess, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4135 Southstream Blvd, Charlotte, NC 28217 Phone: 704-631-1200
Stephanie Dawn Ferlic, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6900 Farmingdale Dr, Charlotte, NC 28212 Phone: 704-910-5810
Brooke Alyssa Davis, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2711 Randolph Rd Ste 400, Charlotte, NC 28207 Phone: 704-342-1900 Fax: 704-377-0353
Angela Devincent Booth, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1001 Blythe Blvd, Medical Center Plaza Suite 200, Charlotte, NC 28203 Phone: 704-381-8840

Mark Benton Moore, ARNP - Medicare Nurse Practitioner in Charlotte, NC