DR. JOHN T MOON (MD, PHD) – Surgery Physician, NPI 1558456319
Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
300 GENERAL SURGERY in KS
Provider Addresses for DR. JOHN T MOON (MD, PHD)
9301 W 74th St Ste 110
Merriam, KS 662042207
Phone: (913) 632-9200
Fax: (913) 632-9209
Type: Location
3660 Park Sierra Dr
Suite 105
Riverside, CA 925053081
Phone: (661) 304-8539
Fax: (951) 278-8913
Type: Location
2111 EXCHANGE ST
ASTORIA, OR 971033329
Phone: (503) 325-4321
Type: Mailing
2055 EXCHANGE ST STE 270
ASTORIA, OR 971033419
Phone: (503) 338-4670
Type: Location
West 74th Street, Kings Cove Apartments, Merriam, Johnson County, Kansas, 66203, United States
MERRIAM, KS 662042207
Phone: (913) 632-9200
Fax: (913) 632-9209
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 7 Open Payments records for all available years, with a total value of $148.
Total Amount is formed as General ($148) + Research ($0) + Ownership ($0) = $148.
Last reported payment date: 2024-05-14 • Largest payer in this snapshot: Organogenesis Inc. ($25).
Total Amount
$148
General + Research + Ownership
Payments
7
Total payment records
General Amount
$148
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-14
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: 2024-09-12
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20091014000646 | I | General Surgery | CA | TBD |
| I20200428000225 | I | General Surgery | MD | TBD |
| I20240912004041 | I | General Surgery | OR | 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 |
|---|---|---|---|---|
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 100 | 100 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 70 | 59 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 46 | 39 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 29 | 28 | $0 |
| 49650 | Repair of groin hernia using an endoscope | 23 | 23 | $0 |
Insurance plans in this area (ZIP 66204)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Orthopedic Surgery | IA | |
| Pulmonary Disease | OR | |
| - | OR | |
| Nurse Practitioner | OR | |
| Certified Registered Nurse Anesthetist (Crna) | MO | |
| Emergency Medicine | WA | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WA | |
| Diagnostic Radiology | ME | |
| - | CO |
Reviews
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