DR. JUSTIN DEAN MOODY (D.O.) – Emergency Medicine Physician, NPI 1639370489
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,351 EMERGENCY MEDICINE in MO
Provider Addresses for DR. JUSTIN DEAN MOODY (D.O.)
1000 E Cherry St
Troy, MO 633791513
Phone: (636) 528-8551
Type: Location
1400 US Highway 61
Festus, MO 630284100
Phone: (636) 933-1111
Type: Location
615 S New Ballas Rd
Saint Louis, MO 631418221
Phone: (314) 251-6090
Type: Location
434 N West St
Perryville, MO 637751359
Phone: (573) 547-2536
Type: Location
901 E 5th St
Washington, MO 630903127
Phone: (636) 239-8011
Type: Location
611, West High Street, Peoria, Peoria County, Illinois, 61606, United States
PEORIA, IL 616061926
Phone: (309) 922-9107
Type: Mailing
Saint Francis Medical Center, 530, Northeast Glen Oak Avenue, Peoria, Peoria County, Illinois, 61637, United States
PEORIA, IL 616033133
Phone: (309) 655-4060
Type: Location
PO BOX 776084
CHICAGO, IL 606776084
Phone: (314) 364-4200
Type: Mailing
10010 KENNERLY RD
SAINT LOUIS, MO 631282106
Phone: (314) 525-1906
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: 2009-05-01
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 |
|---|---|---|---|---|
| I20090501000126 | I | Emergency Medicine | MO | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63379)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine, Internal Medicine | IL | |
| Emergency Medicine | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Physician Assistant | MO | |
| N E U R O L O G Y | AR | |
| Internal Medicine | MO |
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