Nicole M Moore, APN - Medicare Nurse Practitioner in Rockford, IL

  1. Home
  2. Nurse Practitioner
  3. IL
  4. Rockford
Nicole M Moore, APN is a medicare enrolled "Nurse Practitioner - Family" in Rockford, Illinois. Her current practice location is 3401 N Perryville Rd, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 971-2000.

Nicole M Moore is licensed to practice in Illinois (license number 209-014814) 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 1295188803.

Contact Information

Nicole M Moore, APN
3401 N Perryville Rd,
Rockford, IL 61114-8011
(815) 971-2000
(815) 971-9570

Map and Direction




Provider's Profile

Full NameNicole M Moore
GenderFemale
SpecialityNurse Practitioner - Family
Location3401 N Perryville Rd, Rockford, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1295188803
  • Provider Enumeration Date: 07/19/2016
  • Last Update Date: 03/14/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0547557480
  • Enrollment ID: I20160921001166

Medical Identifiers

Medical identifiers for Nicole M Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1295188803NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 041390820 (Illinois)Secondary
363LF0000XNurse Practitioner - Family 209-014814 (Illinois)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. Nicole M Moore allows following entities to bill medicare on her behalf.
Entity NameRockford Health Physicians
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1043242886
PECOS PAC ID: 2567374036
Enrollment ID: O20031103000584
Entity NameSaint Anthony Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942248802
PECOS PAC ID: 5496654006
Enrollment ID: O20040102000555
Entity NameOsf Multi-specialty Group
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1922445527
PECOS PAC ID: 3678889789
Enrollment ID: O20150904000279

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. Nicole M 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 AddressPractice Location Address
Nicole M Moore, APN
3401 N Perryville Rd,
Rockford, IL 61114-8011

Ph: (815) 971-2000		Nicole M Moore, APN
3401 N Perryville Rd,
Rockford, IL 61114-8011

Ph: (815) 971-2000

Reviews and Comments


Nurse Practitioner Nurses in Rockford, IL

Misty Lynn Dehaven, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1639 N Alpine Rd Ste 260, Rockford, IL 61107
Phone: 815-395-1500    Fax: 815-395-1415
Candice Vicencio, DNP, FNP-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4215 Newburg Rd, Rockford, IL 61108
Phone: 815-988-8500    Fax: 815-977-5956
Caryn Ann Ruzic, APRN
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1200 W State St, Rockford, IL 61102
Phone: 815-490-1600    Fax: 815-490-1881
Tyler James Rafferty, FNP-BC
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 5666 E State St, Rockford, IL 61108
Phone: 815-226-2000    
Angela Giardono, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 5666 E State St, Rockford, IL 61108
Phone: 815-226-2000    
Melissa L. Inman, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 461 N Mulford Rd Ste 3, Rockford, IL 61107
Phone: 815-227-9594    Fax: 815-227-9574
Michelle L Bennett, APRN
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 3505 N Bell School Rd, Rockford, IL 61114
Phone: 779-696-0300    Fax: 815-639-9433

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.