Mrs Kim Marie Moore, FNP-C in Los Angeles, CA

Mrs Kim Marie Moore, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Los Angeles, California. Her current practice location is 1670 E 120th St, N S Bldg Room 2c06, Los Angeles, California. You can reach out to her office (for appointments etc.) via phone at (424) 338-1501.

Mrs Kim Marie Moore is licensed to practice in California (license number 513012) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1487916250.

Contact Information

	Mrs Kim Marie Moore, FNP-C
	1670 E 120th St, N S Bldg Room 2c06, Los Angeles, CA 90059-3026
	(424) 338-1501
	(310) 632-3748

Map and Direction

Provider's Profile

Full Name	Mrs Kim Marie Moore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1670 E 120th St, Los Angeles, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487916250
Provider Enumeration Date: 06/08/2012
Last Update Date: 11/17/2014

Medicare PECOS Information:

PECOS PAC ID: 5597171470
Enrollment ID: I20210302000993

Medical Identifiers

Medical identifiers for Mrs Kim Marie Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487916250	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	513012 (California)	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. Mrs Kim Marie Moore allows following entities to bill medicare on her behalf.

Entity Name	County Of Los Angeles
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1780877613 PECOS PAC ID: 1850296534 Enrollment ID: O20090713000358

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. Mrs Kim Marie 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
Mrs Kim Marie Moore, FNP-C 1670 E 120th St, N S Bldg Room 2c06, Los Angeles, CA 90059-3026 Ph: (424) 338-1501	Mrs Kim Marie Moore, FNP-C 1670 E 120th St, N S Bldg Room 2c06, Los Angeles, CA 90059-3026 Ph: (424) 338-1501

Reviews and Comments

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Mrs Kim Marie Moore, FNP-C - Medicare Nurse Practitioner in Los Angeles, CA