1. Home
  2. Directory
  3. Utah
  4. Salt Lake City
  5. Pediatrics
  6. NPI Profile

DOMINIC MOORE M.D.
NPI 1265766026
Pediatrics - Hospice and Palliative Medicine in Salt Lake City, UT

Active since September 28, 2009PECOS EnrolledAccepts Medicare Assignment
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113(801) 662-3645 Get Directions Write a Review

NPPES record last updated: November 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dominic Moore M.d. NPPES

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

DOMINIC MOORE M.D. (NPI 1265766026) is an individual hospice and palliative medicine provider in Salt Lake City, Utah, licensed in Utah (8598327-1205) and active in the NPI registry since September 2009. He is enrolled in Medicare PECOS and is a graduate of State University Of Ny Upstate Medical University (2008).

NPPES Registry Identity

NPI1265766026
Entity TypeIndividualMale
Primary Taxonomy2080H0002X
Provider Legal NameDOMINIC MOORECredential: M.D.
Location Address100 MARIO CAPECCHI DRSalt Lake City, UT 84113-1103
Mailing Address100 Mario Capecchi DrSalt Lake City, UT 84113-1103 · (801) 662-3645
Phone(801) 662-3645
Sole ProprietorNo
Medical School CMSState University Of Ny Upstate Medical UniversityGraduated 2008
Enumeration DateSeptember 28, 2009
Last NPPES UpdateNovember 30, 2021
NPPES CertifiedNovember 30, 2021
✔ NPI 1265766026 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080H0002X
License✔ Licensed in UT · 8598327-1205
Definition
A pediatrician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Also ListedPediatricsTaxonomy 208000000X · License 8598327-1205 (UT)
100 MARIO CAPECCHI DR, Salt Lake City, UT 84113
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Select Health.Insurance ›

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

Dominic 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.

PECOS PAC ID4183801335
PECOS Enrollment IDI20130710000269
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 Reassignments

3

Medicare enrollment records show Dominic Moore reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ihc Health Services Inc
Same address
Neonatal-Perinatal Medicine
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 3,691 clinicians in this Medicare group
NPI 1497473375 (801) 442-5000
University Of Utah Pediatric Acuity Care
Same address
Pediatric Emergency Medicine
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 202 clinicians in this Medicare group
NPI 1538523675 (801) 587-6336
University Of Utah Pediatric Services
Same address
Pediatric Otolaryngology
100 N MARIO CAPECCHI DR
Salt Lake City, UT 84113
  • Reassigned Medicare billing, Utah enrollment
  • 751 clinicians in this Medicare group
NPI 1063876100 (801) 587-6336

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

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.

KAITLIN CARPENTER
Pediatrics
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1000
DR. NICOLE JEFFREYS MD
Anesthesiology (Pediatric Anesthesiology)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-3578
SARAH ZOBELL NP
Nurse Practitioner (Pediatrics)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-1619
MRS. GIOVANA MARTENDAL KING NNP-BC
Nurse Practitioner (Neonatal, Critical Care)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-4100
DR. STEVEN SHI-FONG WU
Pediatrics (Pediatric Gastroenterology)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-2900
KRISTA SKYE VIAU MS, RD, CSP, CD
Dietitian, Registered (Nutrition, Metabolic)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 587-9590
DR. ANDREW GERALD SMITH M.D.
Pediatrics (Pediatric Critical Care Medicine)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-3673
MARY HUNT MARTIN MD
Pediatrics (Pediatric Cardiology)
100 MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Salt Lake County (801) 662-5400

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 Dominic Moore's NPI number?

The NPI number for Dominic Moore is 1265766026. It was assigned to this individual provider in the NPPES registry on September 28, 2009.

Where is Dominic Moore located?

Dominic Moore practices at 100 Mario Capecchi Dr, Salt Lake City, UT 84113. The listed phone number is (801) 662-3645.

What is Dominic Moore's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Hospice and Palliative Medicine, with taxonomy code 2080H0002X.

Is Dominic Moore enrolled in Medicare?

Yes. Dominic 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 Dominic Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dominic Moore reassigns Medicare benefits to 3 organizations: Ihc Health Services Inc (Salt Lake City, UT), University Of Utah Pediatric Acuity Care (Salt Lake City, UT) and University Of Utah Pediatric Services (Salt Lake City, UT). 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 Dominic Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dominic Moore accept?

Health plans from Select Health list Dominic Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Dominic Moore was last updated on November 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.