RICHARD JR. MOORE – Nephrology Physician, NPI 1861479834

RICHARD JR. MOORE is a healthcare provider. based in St louis park, Minnesota. specializing in NEPHROLOGY, INTERNAL MEDICINE. They hold a License No. 34906 (MN). The NPI Number for RICHARD JR. MOORE is 1861479834

Main info

Male
36 Years Of Experience
Accepts Medicare Assignment
Name
RICHARD JR. MOORE
NPI
1861479834
Phone
Not provided
Address
3800 PARK NICOLLET BLVD
Enumeration Date
29 December 2005
Last Update Date
5 March 2012

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
9529938900
Graduation Year
1990 (36 years ago)
PAC ID
9133264146
Group Practice PAC ID
7911819438
Professional Enrollment ID
I20100302000604
Address ID
MN554462307PL4155X101X400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

274 NEPHROLOGY in MN

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Provider Addresses for RICHARD JR. MOORE

  • 3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States

    CREDENTIALING

    ST LOUIS PARK, MN 554162527

    Phone:

    Type: Mailing

  • Louisiana Avenue South, Brooklawns, Saint Louis Park, Hennepin County, Minnesota, 55416:55426, United States

    SUITE W300

    ST LOUIS PARK, MN 554264375

    Phone: (952) 993-3265

    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: 2010-03-02

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
I20100302000604INephrologyMNTBD

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
36415Insertion of needle into vein for collection of blood sample22091$0
90960Dialysis services, 4 or more physician visits per month (20 years or older)11720$0
99214Established patient office or other outpatient visit, 30-39 minutes10475$0
90961Dialysis services, 2-3 physician visits per month (20 years or older)10123$0
85018Blood count, hemoglobin9846$0
View full utilization report →

Insurance plans in this area (ZIP 55416)

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Provider's Procedures

RICHARD JR. MOORE performs procedures in NEPHROLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
NEPHROLOGYMN90935Hemodialysis procedure with one physician evaluation10042
NEPHROLOGYMN90961Dialysis services (2-3 physician visits per month), patient 20 years of age and older7227

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: 7911819438View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YMN
Family PracticeMN
-MN
Pulmonary Disease, Critical Care (Intensivists), Internal MedicineMN
Cardiac ElectrophysiologyMN
Family PracticeMN
Physician AssistantMN
Physical Therapist In Private PracticeMN
Physician AssistantMN
D E R M A T O L O G YMN

Reviews

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Frequently asked questions

Can I cross-check RICHARD JR. MOORE using NPI 1861479834?
NPI 1861479834 belongs to RICHARD JR. MOORE; compare other details if you need extra assurance.
Is RICHARD JR. MOORE shown as active in public data?
Registry records indicate RICHARD JR. MOORE maintains an active NPI.
How would a patient describe RICHARD JR. MOORE's focus?
For RICHARD JR. MOORE, the primary taxonomy reads as Nephrology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with RICHARD JR. MOORE?
Directory geography for RICHARD JR. MOORE centers on St Louis Park, Minnesota.
Can I trust this NPI listing for RICHARD JR. MOORE?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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