MINDY STUTZMAN MOORE (PH.D.) – Clinical Psychologist, NPI 1356744593
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MINDY STUTZMAN MOORE (PH.D.)
1235A N CLYBOURN AVE STE 210
CHICAGO, IL 606101707
Phone:
Type: Mailing
1920 NERGE RD
ELK GROVE VILLAGE, IL 600072972
Phone: (954) 835-2835
Type: Location
4801 W PETERSON AVE STE 601
CHICAGO, IL 606465728
Phone: (847) 329-9210
Fax: (773) 347-2656
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
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Open Payments (CMS)
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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: 2018-05-14
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180514001614 | I | Clinical Psychologist | IL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 96133 | Evaluation of neuropsychological test, each additional hour | 572 | 100 | $0 |
| 96132 | Evaluation of neuropsychological test, first hour | 170 | 121 | $0 |
Insurance plans in this area (ZIP 60610)
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