KYLE VON MOORE (D.O.) – Family Medicine Physician, NPI 1154785616
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,075 FAMILY PRACTICE in MN
Provider Addresses for KYLE VON MOORE (D.O.)
200 1st St SW
Rochester, MN 559050001
Phone: (507) 284-2511
Type: Location
501, Chipeta Way, Research Park, Salt Lake City, Salt Lake County, Utah, 84108, United States
SALT LAKE CITY, UT 841081222
Phone: (801) 581-7951
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: 2020-08-13
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 |
|---|---|---|---|---|
| I20200813000157 | I | Family Practice | MT | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 288 | 163 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 109 | 93 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 103 | 103 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 41 | 33 | $0 |
| 99495 | Transitional care management services for problem of at least moderate complexity | 17 | 15 | $0 |
Insurance plans in this area (ZIP 55905)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MT | |
| Hospitalist, Internal Medicine | MT | |
| Family Practice | MT | |
| A N E S T H E S I O L O G Y | ID | |
| Physician Assistant | MT | |
| Nurse Practitioner | MT | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Internal Medicine, Hematology/Oncology | MT | |
| - | OK | |
| Physician Assistant | WA |
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