ANNE MARIE MOORE – Sports Medicine (Family Medicine) Physician, NPI 1770550188
Sports Medicine (Family Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
243 SPORTS MEDICINE in MN
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Provider Addresses for ANNE MARIE MOORE
3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States of America
CREDENTIALING
ST LOUIS PARK, MN 554162527
Phone:
Type: Mailing
Excelsior Blvd, Monterey Drive, Wolfe Park, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
SUITE 160
ST LOUIS PARK, MN 554264744
Phone: (952) 993-7700
Type: Location
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: 2005-04-20
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 |
|---|---|---|---|---|
| I20050420000598 | I | Sports Medicine | MN | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 438 | 83 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 130 | 111 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 110 | 91 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 62 | 62 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 35 | 35 | $0 |
Insurance plans in this area (ZIP 55416)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| SPORTS MEDICINE | MN | 20610 | Aspiration and/or injection of large joint or joint capsule | 65 | 49 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Medicine And Rehabilitation | MN | |
| Orthopedic Surgery | MN | |
| Occupational Therapist In Private Practice | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| - | MN |
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