LAUREN ELISE MOAK (MD) – Family Medicine Physician, NPI 1073990503

LAUREN ELISE MOAK (MD) is a healthcare provider. based in Melbourne, Florida. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. ME143008 (FL). The NPI Number for LAUREN ELISE MOAK (MD) is 1073990503

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
LAUREN ELISE MOAK (MD)
NPI
1073990503
Phone
(321) 952-9696
Address
PO BOX 1137
Enumeration Date
5 May 2015
Last Update Date
3 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3212416800
Graduation Year
2015 (11 years ago)
PAC ID
7911202114
Group Practice PAC ID
0446201768
Professional Enrollment ID
I20160725003013
Address ID
FL329552742RO220XXBLVD301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:11State licenses:1Digital endpointsOther names

6,722 FAMILY PRACTICE in FL

Provider Addresses for LAUREN ELISE MOAK (MD)

  • PO BOX 1137

    MELBOURNE, FL 329021137

    Phone: (321) 952-9696

    Fax: (321) 952-7937

    Type: Mailing

  • 220 BARTON BLVD UNIT C-14

    ROCKLEDGE, FL 329552742

    Phone: (321) 241-6800

    Fax: (321) 241-6890

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-07-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240717000358IFamily PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32902)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446201768View full group profile
NameSpecialtyState
Internal Medicine, EndocrinologyFL
Physician AssistantFL
Nurse PractitionerFL
Nurse PractitionerFL
P S Y C H I A T R YFL
Family Practice, Peripheral Vascular DiseaseFL
Nurse PractitionerFL
Clinical Social WorkerFL
Psychiatry, NeurologyFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Does LAUREN ELISE MOAK (MD) have a public NPI I can cite?
Public records show LAUREN ELISE MOAK (MD) under NPI 1073990503.
Is LAUREN ELISE MOAK (MD) currently accepting referrals based on NPI status?
Registry metadata lists LAUREN ELISE MOAK (MD) as active.
What type of care does LAUREN ELISE MOAK (MD) provide?
LAUREN ELISE MOAK (MD)'s profile centers on Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to LAUREN ELISE MOAK (MD)?
LAUREN ELISE MOAK (MD) is associated with Melbourne, Florida in the same public data insurers reference.
Can I export LAUREN ELISE MOAK (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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