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MRS. MELANIE DAWN MOORE NP
NPI 1205187861
Nurse Practitioner - Adult Health in Louisville, KY

Active since September 24, 2012PECOS Enrolled
120 EXECUTIVE PARK, LOUISVILLE, KY 40207(502) 855-7200(502) 855-7201 Get Directions Write a Review

NPPES record last updated: October 28, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mrs. Melanie Dawn Moore Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. MELANIE DAWN MOORE NP (NPI 1205187861) is an individual adult health provider in Louisville, Kentucky, licensed in Kentucky (3007505) and active in the NPI registry since September 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205187861
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. MELANIE DAWN MOORECredential: NP
Location Address120 EXECUTIVE PARKLouisville, KY 40207-4201
Mailing Address223 Executive ParkLouisville, KY 40207-4202 · (502) 907-0356
Phone(502) 855-7200
Fax(502) 855-7201
Sole ProprietorYes
Enumeration DateSeptember 24, 2012
Last NPPES UpdateOctober 28, 2020
NPPES CertifiedOctober 28, 2020
✔ NPI 1205187861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in KY · 3007505
120 EXECUTIVE PARK, Louisville, KY 40207
Open in Google Maps ↗

Other Identifiers 2

Medicaid7100654320KY
Medicaid300035632IN

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Melanie Dawn Moore Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Melanie Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Commonwealth Pain Associates, PLLC
Same address
Interventional Pain Medicine
120 EXECUTIVE PARK
Louisville, KY 40207
  • Reassigned Medicare billing, Kentucky enrollment
  • 193 clinicians in this Medicare group
NPI 1306280177 (502) 855-7200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40207 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLAKE EVANS MD
Anesthesiology
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
JAMES W JACKSON JR. MD
Anesthesiology (Pain Medicine)
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
SHAUN NELSON PA
Physician Assistant
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
BARBARA J LEMMONS ARNP
Nurse Practitioner (Adult Health)
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
COMMONWEALTH PAIN ASSOCIATES, PLLC
Pain Medicine (Interventional Pain Medicine)
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
ISMAEL CANDELARIO FERNANDEZ
Physician Assistant
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
MARY KATHERINE HALE APRN
Nurse Practitioner (Family)
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200
KELSEY CHARLOTTE O'MARA PA-C
Physician Assistant
120 EXECUTIVE PARK
LOUISVILLE, KY 40207
Jefferson County (502) 855-7200

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 Melanie Moore's NPI number?

The NPI number for Melanie Moore is 1205187861. It was assigned to this individual provider in the NPPES registry on September 24, 2012.

Where is Melanie Moore located?

Melanie Moore practices at 120 Executive Park, Louisville, KY 40207. The listed phone number is (502) 855-7200.

What is Melanie Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Is Melanie Moore enrolled in Medicare?

Yes. Melanie Moore is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Melanie Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melanie Moore reassigns Medicare benefits to Commonwealth Pain Associates, PLLC (Louisville, KY). The 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 Melanie Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Melanie Moore was last updated on October 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.