Susan John Moore, FNP in Kokomo, IN - Medicare Nurse Practitioner

Susan John Moore, FNP is a medicare enrolled "Nurse Practitioner - Family" in Kokomo, Indiana. Her current practice location is 3118 South Lafountain, Indiana Health Center - Kokomo, Kokomo, Indiana. You can reach out to her office (for appointments etc.) via phone at (765) 864-4160.

Susan John Moore is licensed to practice in Indiana (license number 71003756A) 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 1134400864.

Contact Information

	Susan John Moore, FNP
	3118 South Lafountain, Indiana Health Center - Kokomo, Kokomo, IN 46902-3710
	(765) 864-4160
	(765) 864-4166

Map and Direction

Provider's Profile

Full Name	Susan John Moore
Gender	Female
Speciality	Nurse Practitioner - Family
Location	3118 South Lafountain, Kokomo, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1134400864
Provider Enumeration Date: 09/08/2011
Last Update Date: 01/24/2023

Medicare PECOS Information:

PECOS PAC ID: 4789840885
Enrollment ID: I20120718000001

Medical Identifiers

Medical identifiers for Susan John Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1134400864	NPI	-	NPPES
100071250A	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	71003756A (Indiana)	Secondary
363LF0000X	Nurse Practitioner - Family	71003756A (Indiana)	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. Susan John Moore allows following entities to bill medicare on her behalf.

Entity Name	Indiana Health Centers Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598776742 PECOS PAC ID: 3971599473 Enrollment ID: O20040430001159

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. Susan John 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
Susan John Moore, FNP 8003 Castleway Dr, Indianapolis, IN 46250-1946 Ph: (317) 576-1335	Susan John Moore, FNP 3118 South Lafountain, Indiana Health Center - Kokomo, Kokomo, IN 46902-3710 Ph: (765) 864-4160

Reviews and Comments

Nurse Practitioner Nurses in Kokomo, IN

Cathy J Simms, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3500 S Lafountain St, Kokomo, IN 46902 Phone: 765-453-8571 Fax: 765-453-8637
Miranda Tedder, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3611 S Reed Rd Ste 214, Kokomo, IN 46902 Phone: 765-776-8700
Mandy Vires, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 429 W Lincoln Rd, Kokomo, IN 46902 Phone: 317-654-3487
Raymond Candelaria, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3611 S Reed Rd Ste 214, Kokomo, IN 46902 Phone: 765-776-8700
Mrs. Lisa D Stults, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1907 W Sycamore St, Kokomo, IN 46901 Phone: 765-456-5900
Angela J Bowman, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2401 Columbus Blvd, Kokomo, IN 46901 Phone: 765-453-1254 Fax: 765-864-8732
Mary Hendrix, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3118 S Lafountain St # At, Kokomo, IN 46902 Phone: 765-864-4160

Susan John Moore, FNP - Medicare Nurse Practitioner in Kokomo, IN