Ms Patricia Louise Moore, MEDICAID PROVIDER is a
Physician Assistant - Medical based in Indianaplis, Indiana. Ms Patricia Louise Moore is licensed to practice in Indiana (license number 200974970A) and her current practice location is
1453 S. Bancroft, Indianaplis, Indiana. She can be reached at her office (for appointments etc.) via phone at
(317) 410-7339.
NPI number for Ms Patricia Louise Moore is 1356643324 and her current mailing address is 3601 Decamp Dr, Indianapolis, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1356643324.
Provider's Profile
Full Name | Ms Patricia Louise Moore |
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Gender | Female |
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Speciality | Physician Assistant - Medical |
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Location | 1453 S. Bancroft, Indianaplis, Indiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1356643324
- Provider Enumeration Date: 11/24/2010
- Last Update Date: 05/04/2011
Medical Identifiers
Medical identifiers for Ms Patricia Louise Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1356643324 | NPI | - | NPPES |
304563020A | Other | IN | MEDICARE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 200974970A (Indiana) | Primary |
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. Ms Patricia Louise Moore is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Patricia Louise Moore, MEDICAID PROVIDER 3601 Decamp Dr, Indianapolis, IN 46226-6040 Ph: (317) 410-7339 | Ms Patricia Louise Moore, MEDICAID PROVIDER 1453 S. Bancroft, Indianaplis, IN 46203-3709 Ph: (317) 410-7339 |
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