DR. MICHAEL R MOORE (M.D.) – Family Medicine Physician, NPI 1336302280

DR. MICHAEL R MOORE (M.D.) is a healthcare provider. based in Ellington, Missouri. specializing in Family Medicine Physician. They hold the professional credentials M.D.. They hold a License No. R4837 (MO). The NPI Number for DR. MICHAEL R MOORE (M.D.) is 1336302280

Main info

Male
55 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL R MOORE (M.D.)
NPI
1336302280
Phone
(573) 663-2313
Address
PO BOX 157
Enumeration Date
9 July 2008
Last Update Date
19 July 2012

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
5735984213
Graduation Year
1971 (55 years ago)
PAC ID
7416852561
Group Practice PAC ID
6709871007
Professional Enrollment ID
I20081003000474
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

Provider Addresses for DR. MICHAEL R MOORE (M.D.)

  • PO BOX 157

    ELLINGTON, MO 636380157

    Phone: (573) 663-2313

    Fax: (573) 663-2322

    Type: Mailing

  • 1003 SOUTH MAIN STREET

    EMININCE, MO 654660100

    Phone: (573) 226-5505

    Fax: (573) 226-5584

    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: 2008-10-03

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
I20081003000474IFamily PracticeMOTBD

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 63638)

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Provider's Procedures

DR. MICHAEL R MOORE (M.D.) performs procedures in Family Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEMO83036Hemoglobin A1C level10661

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: 6709871007View full group profile
NameSpecialtyState
Clinical Social WorkerMO
Nurse PractitionerMO
Nurse PractitionerTX
Nurse PractitionerMO
Family PracticeMO
-MO
Mental Health CounselorMO
Nurse PractitionerMO
Pulmonary Disease, Critical Care (Intensivists), Critical Care (Intensivists), Pulmonary Disease, Sleep Medicine, Internal MedicineMO
Family PracticeMO

Reviews

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Frequently asked questions

Where can patients find DR. MICHAEL R MOORE (M.D.)'s NPI?
You can confirm DR. MICHAEL R MOORE (M.D.) with NPI 1336302280; it appears in the national provider directory.
Is DR. MICHAEL R MOORE (M.D.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does DR. MICHAEL R MOORE (M.D.) treat or focus on?
Patients typically see DR. MICHAEL R MOORE (M.D.) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. MICHAEL R MOORE (M.D.)?
The snapshot lists Ellington, Missouri for DR. MICHAEL R MOORE (M.D.); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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