JOSEPH KALEB MOORE – Family Medicine Physician, NPI 1104354505

JOSEPH KALEB MOORE is a healthcare provider. based in Louisville, Kentucky. specializing in FAMILY PRACTICE. They hold a License No. 01086091A (IN). The NPI Number for JOSEPH KALEB MOORE is 1104354505

Main info

Male
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
JOSEPH KALEB MOORE
NPI
1104354505
Phone
(502) 852-8696
Address
500 S Preston St Rm 305
Enumeration Date
30 May 2017
Last Update Date
6 July 2021

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
3176219220
Graduation Year
2018 (8 years ago)
PAC ID
3678975745
Group Practice PAC ID
1759416662
Professional Enrollment ID
I20210712003475
Address ID
IN460401373FO545XXDRXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:9State licenses:1Digital endpointsOther names

1,718 FAMILY PRACTICE in KY

Provider Addresses for JOSEPH KALEB MOORE

  • 500 S Preston St Rm 305

    Louisville, KY 402021702

    Phone: (502) 852-8696

    Type: Location

  • 545 VITALITY DR STE 100A

    FORTVILLE, IN 460401373

    Phone: (317) 621-9220

    Fax: (317) 621-9222

    Type: Location

  • 500 S PRESTON ST RM 305

    LOUISVILLE, KY 402021702

    Phone: (502) 852-8696

    Type: Mailing

  • 6626 E 75TH ST STE 500

    INDIANAPOLIS, IN 462502890

    Phone:

    Type: Mailing

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: 2021-07-12

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
I20210712003475IFamily PracticeINTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes5748$0
99214Established patient office or other outpatient visit, 30-39 minutes5626$0
81003Automated urinalysis test1612$0
87428Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza1514$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit1414$0
View full utilization report →

Insurance plans in this area (ZIP 40202)

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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: 1759416662View full group profile

Reviews

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Frequently asked questions

What number should I use to identify JOSEPH KALEB MOORE for billing?
Administrative and clinical systems typically use NPI 1104354505 for JOSEPH KALEB MOORE.
Should I treat JOSEPH KALEB MOORE as an active provider?
Patients and plans typically see JOSEPH KALEB MOORE as active in the national extract.
How should patients interpret JOSEPH KALEB MOORE's specialty?
The extract shows Family Medicine Physician for JOSEPH KALEB MOORE. Clinical services aligned with this taxonomy classification.
Can patients visit JOSEPH KALEB MOORE in Louisville, Kentucky?
For routing, start with Louisville, Kentucky for JOSEPH KALEB MOORE, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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