BRIAN G MOORE (MD) – Surgery Physician, NPI 1205942075
Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
729 GENERAL SURGERY in IN
Provider Addresses for BRIAN G MOORE (MD)
710, North Niles Avenue, South Bend, Saint Joseph County, Indiana, 46617, United States
SOUTH BEND, IN 466171924
Phone: (574) 647-1610
Fax: (574) 237-6069
Type: Mailing
PO BOX 781076
DETROIT, MI 482781076
Phone: (317) 528-4800
Fax: (317) 865-1479
Type: Mailing
900 I ST FL 2
LA PORTE, IN 463505533
Phone: (219) 575-6060
Fax: (219) 575-6004
Type: Location
900, I Street, La Porte, LaPorte County, Indiana, 46350, United States
LA PORTE, IN 463505533
Phone: (219) 324-1700
Fax: (219) 324-1602
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $162.
Total Amount is formed as General ($162) + Research ($0) + Ownership ($0) = $162.
Last reported payment date: 2024-09-19 • Largest payer in this snapshot: Boston Scientific Corporation ($73).
Total Amount
$162
General + Research + Ownership
Payments
6
Total payment records
General Amount
$162
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2008-06-13
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 |
|---|---|---|---|---|
| I20080613000177 | I | General Surgery | IN | 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 |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 53 | 53 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 42 | 37 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 26 | 26 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 21 | 17 | $0 |
| 14021 | Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm | 18 | 16 | $0 |
Insurance plans in this area (ZIP 46617)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| - | IN | |
| - | IN | |
| - | MI | |
| - | IN | |
| - | IN | |
| Family Practice | IN | |
| - | MI | |
| Internal Medicine | IN | |
| Internal Medicine, Emergency Medicine | MI |
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