JACOB MOORMAN (NP) – Acute Care Nurse Practitioner, NPI 1023904695

JACOB MOORMAN (NP) is a healthcare provider. based in Greensburg, Indiana. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 28241590A (IN). The NPI Number for JACOB MOORMAN (NP) is 1023904695

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
JACOB MOORMAN (NP)
NPI
1023904695
Phone
Not provided
Address
2176 N COUNTY ROAD 850 E
Enumeration Date
17 June 2025
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3178512331
Graduation Year
2023 (3 years ago)
PAC ID
7911414412
Group Practice PAC ID
2860304102
Professional Enrollment ID
I20250729003631
Address ID
IN462378600IN8051XAVEX403
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for JACOB MOORMAN (NP)

  • 2176 N COUNTY ROAD 850 E

    GREENSBURG, IN 472408837

    Phone:

    Type: Mailing

  • 8111 S EMERSON AVE

    INDIANAPOLIS, IN 462378601

    Phone: (317) 528-5261

    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: 2025-07-29

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
I20250729003631INurse PractitionerINTBD

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 47240)

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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: 2860304102View full group profile
NameSpecialtyState
Thoracic SurgeryMD
-IL
Nurse PractitionerIL
Physician AssistantIL
-IL
Physician AssistantIN
Physician AssistantIN
Physician AssistantIL
Physician AssistantIL
Nurse PractitionerIN

Reviews

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Frequently asked questions

How is JACOB MOORMAN (NP) identified in CMS data?
CMS-hosted NPPES data lists JACOB MOORMAN (NP) with NPI 1023904695.
Does the file indicate JACOB MOORMAN (NP) is practicing under active NPI?
Directory data currently reports JACOB MOORMAN (NP) as active.
What healthcare role does JACOB MOORMAN (NP) hold?
Scheduling teams often label JACOB MOORMAN (NP) under Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where is JACOB MOORMAN (NP) based?
JACOB MOORMAN (NP) is tied to Greensburg, Indiana in the data we show; additional addresses may exist on the full record.
Why does JACOB MOORMAN (NP) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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