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DR. MARY ELLEN MOORE PH D
NPI 1487735940
Psychologist - Clinical in Chicago, IL

Active since October 18, 2006PECOS EnrolledAccepts Medicare Assignment
2648 W PERSHING RD, CHICAGO, IL 60632(312) 806-1885 Get Directions Write a Review

NPPES record last updated: May 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 20, 2020, Apr 17, 2017 (2 updates tracked since 2017).

About Dr. Mary Ellen Moore Ph D NPPES

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

DR. MARY ELLEN MOORE PH D (NPI 1487735940) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (071002095) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1975).

NPPES Registry Identity

NPI1487735940
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. MARY ELLEN MOORECredential: PH D
Location Address2648 W PERSHING RDChicago, IL 60632-1629
Mailing Address2648 W Pershing RdChicago, IL 60632-1629 · (312) 806-1885
Phone(312) 806-1885
Sole ProprietorNo
Medical School CMSOtherGraduated 1975
Enumeration DateOctober 18, 2006
Last NPPES UpdateMay 20, 20202 updates tracked since enumeration
NPPES CertifiedMay 20, 2020
✔ NPI 1487735940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071002095
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
2648 W PERSHING RD, Chicago, IL 60632
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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 and accepts Medicare assignment

Dr. Mary Ellen Moore Ph 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 ID6709044076
PECOS Enrollment IDI20120220000292
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60632 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
$183.39 typical visit price
range $60.08 – $183.39
Typical copayment $45.84 (range $15.02 – $45.84)
Most-billed visit code 99205
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
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

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

THE CIRCLE EL CIRCULO OF THE SOCIETY OF HELPERS
Psychologist (Clinical)
2648 W PERSHING RD
CHICAGO, IL 60632
Cook County (872) 444-5148

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 Mary Ellen Moore's NPI number?

The NPI number for Mary Ellen Moore is 1487735940. It was assigned to this individual provider in the NPPES registry on October 18, 2006.

Where is Mary Ellen Moore located?

Mary Ellen Moore practices at 2648 W Pershing Rd, Chicago, IL 60632. The listed phone number is (312) 806-1885.

What is Mary Ellen Moore's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Is Mary Ellen Moore enrolled in Medicare?

Yes. Mary Ellen 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.

When was this NPI record last updated?

The NPPES record for Mary Ellen Moore was last updated on May 20, 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.