DR. CHARLES M. MOON (MD) – Dermatology Physician, NPI 1487712295

DR. CHARLES M. MOON (MD) is a healthcare provider. based in Cape girardeau, Missouri. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 01053751A (IN). The NPI Number for DR. CHARLES M. MOON (MD) is 1487712295

Main info

Male
Sole Proprietor
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHARLES M. MOON (MD)
NPI
1487712295
Phone
(573) 335-7546
Address
2116 MEGAN DR
Enumeration Date
5 December 2006
Last Update Date
31 January 2017

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
5733357546
Graduation Year
1999 (27 years ago)
PAC ID
8224191770
Group Practice PAC ID
3678612108
Professional Enrollment ID
I20091123000344
Address ID
MO637011979CA2116XDRXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

337 DERMATOLOGY in MO

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Provider Addresses for DR. CHARLES M. MOON (MD)

  • 2116 MEGAN DR

    STE 102

    CAPE GIRARDEAU, MO 637011979

    Phone: (573) 335-7546

    Fax: (573) 335-7550

    Type: Mailing

  • 1359, North Mount Auburn Road, Cape Girardeau, Cape Girardeau County, Missouri, 63701, United States

    CAPE GIRARDEAU, MO 637011727

    Phone: (573) 335-7546

    Fax: (573) 335-7550

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 285 Open Payments records for all available years, with a total value of $57,292.

Total Amount is formed as General ($57,292) + Research ($0) + Ownership ($0) = $57,292.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($23,904).

Total Amount

$57,292

General + Research + Ownership

Payments

285

Total payment records

General Amount

$57,292

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2009-11-23

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
I20091123000344IDermatologyMOTBD

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
17003Destruction of precancer skin growth, 2-14 growths9,8191,322$0
J3245Injection, tildrakizumab, 1 mg8,10023$0
88305Pathology examination of tissue using a microscope, intermediate complexity3,9272,046$0
99213Established patient office or other outpatient visit, 20-29 minutes3,0572,037$0
17000Destruction of precancer skin growth, 1 growth2,2871,584$0
View full utilization report →

Insurance plans in this area (ZIP 63701)

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Provider's Procedures

DR. CHARLES M. MOON (MD) performs procedures in DERMATOLOGY. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYMO11101Biopsy of each additional growth of skin and/or tissue448280
DERMATOLOGYMO14060Tissue transfer repair of wound (10 sq centimeters or less) of eyelids, nose, ears, and/or lips5048
DERMATOLOGYMO88304Pathology examination of tissue using a microscope, moderately low complexity2929
DERMATOLOGYMO88312Special stained specimen slides to identify organisms including interpretation and report186180

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: 3678612108View full group profile
NameSpecialtyState
Nurse PractitionerMO
Nurse PractitionerMO
D E R M A T O L O G YIL
Nurse PractitionerMO
Nurse PractitionerMO
D E R M A T O L O G YFL
Physician AssistantMO
Nurse PractitionerMO

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Frequently asked questions

How is DR. CHARLES M. MOON (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. CHARLES M. MOON (MD) with NPI 1487712295.
Is DR. CHARLES M. MOON (MD) still practicing?
DR. CHARLES M. MOON (MD) is currently listed as active in the public NPI registry.
What is DR. CHARLES M. MOON (MD) best known for clinically?
Directory data describes DR. CHARLES M. MOON (MD) with Dermatology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. CHARLES M. MOON (MD)?
DR. CHARLES M. MOON (MD)'s geographic hint is Cape Girardeau, Missouri in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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