DR. THEODORE HYUNSUB MOON (M.D.) – Pulmonary Disease Physician, NPI 1568438455

DR. THEODORE HYUNSUB MOON (M.D.) is a healthcare provider. based in Salt lake city, Utah. specializing in PULMONARY DISEASE, CRITICAL CARE (INTENSIVISTS). They hold the professional credentials M.D.. They hold a License No. A60692 (CA). The NPI Number for DR. THEODORE HYUNSUB MOON (M.D.) is 1568438455

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. THEODORE HYUNSUB MOON (M.D.)
NPI
1568438455
Phone
(435) 251-2600
Address
PO BOX 27128
Enumeration Date
28 February 2006
Last Update Date
2 August 2012

Doctor Profile

Medical School Name
BOSTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
8013574600
Graduation Year
1994 (32 years ago)
PAC ID
9335241587
Group Practice PAC ID
1850209420
Professional Enrollment ID
I20120817000114
Address ID
UT846315137FI700XX99XX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

153 PULMONARY DISEASE in UT

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Provider Addresses for DR. THEODORE HYUNSUB MOON (M.D.)

  • PO BOX 27128

    SALT LAKE CITY, UT 841270128

    Phone: (435) 251-2600

    Fax: (435) 251-2610

    Type: Mailing

  • 1380, Medical Center Drive, St. George, Washington County, Utah, 84790, United States

    SUITE 2200

    ST GEORGE, UT 847902123

    Phone: (435) 251-2600

    Fax: (435) 251-2610

    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: 2012-08-17

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
I20120817000114IPulmonary DiseaseUTTBD

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
94729Test to examine how well the lungs exchange gases219216$0
94060Test to measure expiratory airflow and volume changes before and after medication administration159156$0
94726Test to determine lung volumes using sensors142141$0
99214Established patient office or other outpatient visit, 30-39 minutes9857$0
94010Test to measure expiratory airflow and volume7271$0
View full utilization report →

Insurance plans in this area (ZIP 84127)

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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: 1850209420View full group profile

Reviews

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Frequently asked questions

What is DR. THEODORE HYUNSUB MOON (M.D.)'s NPI number?
DR. THEODORE HYUNSUB MOON (M.D.)'s NPI is 1568438455 — the number used across U.S. healthcare to identify this provider.
Is there an active status for DR. THEODORE HYUNSUB MOON (M.D.)?
For scheduling context, DR. THEODORE HYUNSUB MOON (M.D.) is shown as active in the registry.
What expertise is attributed to DR. THEODORE HYUNSUB MOON (M.D.)?
DR. THEODORE HYUNSUB MOON (M.D.)'s specialty line reads Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
Is DR. THEODORE HYUNSUB MOON (M.D.) located near Salt Lake City?
DR. THEODORE HYUNSUB MOON (M.D.) currently maps to Salt Lake City, Utah in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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