MICHAEL S MOORE (MD) – Emergency Medicine Physician, NPI 1720143084

MICHAEL S MOORE (MD) is a healthcare provider. based in Antigo, Wisconsin. specializing in Emergency Medicine Physician. They hold the professional credentials MD. They hold a License No. 41388 (WI). The NPI Number for MICHAEL S MOORE (MD) is 1720143084

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
MICHAEL S MOORE (MD)
NPI
1720143084
Phone
(715) 623-2331
Address
112 E 5TH AVE
Enumeration Date
27 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Secondary Phone
7156232351
Graduation Year
1998 (28 years ago)
PAC ID
5991983751
Group Practice PAC ID
1557271202
Professional Enrollment ID
I20110624000556
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MICHAEL S MOORE (MD)

  • 112, 5th Avenue, Antigo, Langlade County, Wisconsin, 54409, United States

    ANTIGO, WI 544092710

    Phone: (715) 623-2331

    Mailing address matches the actual address.

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: 2022-03-09

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
I20220309002832IEmergency MedicineILTBD

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
99285Emergency department visit with high level of medical decision making145129$0
99284Emergency department visit with moderate level of medical decision making9281$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6458$0
View full utilization report →

Insurance plans in this area (ZIP 54409)

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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: 1557271202View full group profile
NameSpecialtyState
Internal MedicineWI
Nurse PractitionerWI
Nurse PractitionerWI
General SurgeryNJ
Diagnostic RadiologyMI
Interventional Cardiology, Cardiovascular Disease (Cardiology), Otolaryngology, Internal MedicineMN
Physician AssistantWI
Nurse PractitionerWI
Clinical Social WorkerWI
Family PracticeWI

Reviews

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Frequently asked questions

How do payers reference MICHAEL S MOORE (MD)?
For MICHAEL S MOORE (MD), use NPI 1720143084 as the unique 10-digit identifier.
Is MICHAEL S MOORE (MD) shown as active in public data?
Registry records indicate MICHAEL S MOORE (MD) maintains an active NPI.
What area of care is associated with MICHAEL S MOORE (MD)?
MICHAEL S MOORE (MD)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with MICHAEL S MOORE (MD)?
Directory geography for MICHAEL S MOORE (MD) centers on Antigo, Wisconsin.
When was this NPI issued?
Enumeration for MICHAEL S MOORE (MD) is noted as December 27, 2006 where the registry provides it.

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