Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. NICHOLAS SIMON ALEXANDER MOORE MD
NPI 1255066031
Internal Medicine - Pulmonary Disease in Salt Lake City, UT

Q: What is Nicholas Moore's NPI number?

The NPI number for Nicholas Moore is 1255066031. It was assigned to this individual provider in the NPPES registry on July 18, 2022.

Q: What is Nicholas Moore's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Moore was last updated on July 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 52 days 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.

Active since July 18, 2022PECOS Enrolled

30 N MARIO CAPECCHI DR RM 3N100, SALT LAKE CITY, UT 84112(801) 581-2121 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 27, 2025, May 3, 2023, Jul 18, 2022 (3 updates tracked since 2022).

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About Dr. Nicholas Simon Alexander Moore Md NPPES

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

DR. NICHOLAS SIMON ALEXANDER MOORE MD (NPI 1255066031) is an individual pulmonary disease provider in Salt Lake City, Utah, licensed in Montana (MED-PHYS-LIC-166632) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS, is affiliated with Intermountain Medical Center, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1255066031

Entity TypeIndividualMale

Primary Taxonomy207RP1001X

Provider Legal NameDR. NICHOLAS SIMON ALEXANDER MOORECredential: MD

Location Address30 N MARIO CAPECCHI DR RM 3N100Salt Lake City, UT 84112

Mailing Address30 N Mario Capecchi Dr Rm 3n100Salt Lake City, UT 84112 · (801) 581-2121

Phone(801) 581-2121

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJuly 18, 2022

Last NPPES UpdateJuly 2, 20263 updates tracked since enumeration

NPPES CertifiedJuly 2, 2026

✔ NPI 1255066031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RP1001X

License✔ Licensed in MT · MED-PHYS-LIC-166632

Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 14209922-1205 (UT)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MED-RES-LIC-113361 (MT)

30 N MARIO CAPECCHI DR RM 3N100, Salt Lake City, UT 84112

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Nicholas Simon Alexander Moore Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2466836085

PECOS Enrollment IDI20260716004819

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.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Intermountain Medical Center

Acute Care Hospitals · Murray, UT

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460010

Location5121 South Cottonwood StreetMurray, UT 84107 · Salt Lake County

Emergency services Birthing friendly

Riverton Hospital

Acute Care Hospitals · Riverton, UT

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number460058

Location3741 West 12600 SouthRiverton, UT 84065 · Salt Lake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84112 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

$125.70 typical visit price

range $54.34 – $166.03

Typical copayment $31.42 (range $13.58 – $41.50)

Most-billed visit code 99204

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

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 20

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

DR. MERIDETH BROOKE CHILTON MD

Internal Medicine (Nephrology)