DR. TRUDY J MOORE (MD) – Diagnostic Radiology Physician, NPI 1023099488

DR. TRUDY J MOORE (MD) is a healthcare provider. based in Eden prairie, Minnesota. specializing in Diagnostic Radiology Physician. They hold the professional credentials MD. They hold a License No. 16333 (OK). The NPI Number for DR. TRUDY J MOORE (MD) is 1023099488

Main info

Female
46 Years Of Experience
Accepts Medicare Assignment
Name
DR. TRUDY J MOORE (MD)
NPI
1023099488
Phone
(952) 595-1301
Address
11995 SINGLETREE LN
Enumeration Date
10 November 2005
Last Update Date
25 June 2021

Doctor Profile

Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Secondary Phone
4054854778
Graduation Year
1980 (46 years ago)
PAC ID
7416904305
Group Practice PAC ID
2961416946
Professional Enrollment ID
I20050506000768
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

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Provider Addresses for DR. TRUDY J MOORE (MD)

  • 11995, Singletree Lane, Eden Prairie, Hennepin County, Minnesota, 55344, United States

    SUITE 500

    EDEN PRAIRIE, MN 553445347

    Phone: (952) 595-1301

    Fax: (612) 294-4903

    Type: Mailing

  • 7011, Millennium Drive, Fort Smith, Sebastian County, Arkansas, 72916, United States

    FORT SMITH, AR 729168825

    Phone: (952) 595-1100

    Fax: (612) 294-4903

    Type: Location

  • 11995 SINGLETREE LN STE 500

    EDEN PRAIRIE, MN 553445349

    Phone: (952) 595-1301

    Fax: (612) 294-4903

    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: 2019-03-27

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050506000768IDiagnostic RadiologyOKTBD
I20160621002483IDiagnostic RadiologyTXTBD
I20190327002602IDiagnostic RadiologyARTBD

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 55344)

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Provider's Procedures

DR. TRUDY J MOORE (MD) performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYOK71010X-ray of chest, 1 view, front4140
DIAGNOSTIC RADIOLOGYOK74177CT scan of abdomen and pelvis with contrast2727

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: 2961416946View full group profile
NameSpecialtyState
LATIKA SINHA PRASAD (MD)
Diagnostic RadiologyPA
DR. PETER BOHUSLAV ZELINKA (M.D.)
Diagnostic RadiologyMN
KIMBERLY ELAINE FAGEN (M.D.)
Diagnostic RadiologyMN
DR. DAVID SCOTT ST. JOHN (M.D.)
Diagnostic RadiologyMN
DR. JONATHAN MICHAEL FORAL (M.D.)
Diagnostic RadiologyMN
DR. CHRISTOPHER EUGENE RICKMAN (MD)
Diagnostic RadiologyMN
NAUSHEEN NAVEED (MBBS)
Diagnostic RadiologyMN
CLARENCE COOLIDGE JR. COLEMAN (M.D.)
Diagnostic Radiology, Interventional RadiologyMN
JACOB E BROWN (D.O.)
Internal Medicine, Diagnostic RadiologyPA
JOSEPH C CAPITO (MD)
Diagnostic RadiologyWV

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Frequently asked questions

Can I verify DR. TRUDY J MOORE (MD) with an NPI only?
You can start verification with NPI 1023099488 for DR. TRUDY J MOORE (MD), then check state licensing separately.
Is DR. TRUDY J MOORE (MD) listed as active for patients and plans?
The listing shows DR. TRUDY J MOORE (MD) as active in the NPI system.
What taxonomy line describes DR. TRUDY J MOORE (MD)?
For research purposes, treat DR. TRUDY J MOORE (MD) as Diagnostic Radiology Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect DR. TRUDY J MOORE (MD) on a map?
Expect Eden Prairie, Minnesota as a primary anchor for DR. TRUDY J MOORE (MD) unless the record lists multiple sites.
Why does DR. TRUDY J MOORE (MD) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.