DR. EVAN CORLEE MOORE M.D.
NPI 1205053063
Emergency Medicine in Salt Lake City, UT
About Dr. Evan Corlee Moore M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. EVAN CORLEE MOORE M.D. (NPI 1205053063) is an individual emergency medicine provider in Salt Lake City, Utah, licensed in Utah (7372509-1205) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS, is affiliated with Mckay-dee Hospital, and is a graduate of University Of Utah School Of Medicine (2005).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Evan Corlee Moore M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
3Medicare enrollment records show Evan Moore reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Murray, UT 84107
- Reassigned Medicare billing, Utah enrollment
- 3,691 clinicians in this Medicare group
Salt Lake City, UT 84102
- Reassigned Medicare billing, Utah enrollment
- 316 clinicians in this Medicare group
Aventura, FL 33180
- Reassigned Medicare billing, Utah enrollment
- 13 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mckay-Dee Hospital
Acute Care Hospitals · Ogden, UTSt. George Regional Hospital
Acute Care Hospitals · St George, UTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SALT LAKE CITY, UT 84107
MURRAY, UT 84107
SALT LAKE CITY, UT 84107
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Evan Moore's NPI number?
The NPI number for Evan Moore is 1205053063. It was assigned to this individual provider in the NPPES registry on April 20, 2007.
Where is Evan Moore located?
Evan Moore practices at 5121 S Cottonwood St, Salt Lake City, UT 84107. The listed phone number is (801) 910-3595.
What is Evan Moore's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Evan Moore enrolled in Medicare?
Yes. Evan Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Evan Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Evan Moore reassigns Medicare benefits to 3 organizations: Ihc Health Services Inc (Murray, UT), Emergency Physicians Integrated Care, LLC (Salt Lake City, UT) and Intensive Care Consortium Inc (Aventura, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Evan Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Evan Moore affiliated with any hospitals?
According to CMS data, Evan Moore is affiliated with Mckay-Dee Hospital and St. George Regional Hospital.
When was this NPI record last updated?
The NPPES record for Evan Moore was last updated on September 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Evan Corlee Moore, M.D. · NPI 1205053063
Emergency Medicine physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since April 20, 2007.
## Identity
- **NPI:** 1205053063 (Entity type: Individual)
- **Enumerated:** April 20, 2007
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 7372509-1205 (Utah)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 5121 S COTTONWOOD ST, Salt Lake City, UT 84107-5701
- **Phone:** (801) 910-3595
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Ihc Health Services Inc (NPI 1659569358, Murray, UT); Emergency Physicians Integrated Care, LLC (NPI 1578598199, Salt Lake City, UT); Intensive Care Consortium Inc (NPI 1629019062, Aventura, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Utah School Of Medicine, class of 2005
## Record status
- **NPPES last updated:** September 14, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1205053063) · Data from the CMS NPPES public registry.