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MICHAEL MOORE
NPI 1619635117
Nurse Practitioner - Psychiatric/Mental Health in Medina, OH

Active since December 01, 2021PECOS Enrolled
94.42/100
CMS Quality Rating
3593 MEDINA RD # 181, MEDINA, OH 44256(330) 536-3746 Get Directions Write a Review

NPPES record last updated: April 8, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 8, 2022, Dec 1, 2021 (2 updates tracked since 2021).

About Michael Moore NPPES

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

MICHAEL MOORE (NPI 1619635117) is an individual psychiatric/mental health provider in Medina, Ohio, licensed in Ohio (0030981) and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619635117
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMICHAEL MOORE
Location Address3593 MEDINA RD # 181Medina, OH 44256-8182
Mailing Address3220 S Locust StDenver, CO 80222-7410
Phone(330) 536-3746
Sole ProprietorNo
Enumeration DateDecember 1, 2021
Last NPPES UpdateApril 8, 20222 updates tracked since enumeration
NPPES CertifiedMarch 14, 2022
✔ NPI 1619635117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in OH · 0030981
Also ListedRegistered NurseTaxonomy 163W00000X · License 478286 (OH)
3593 MEDINA RD # 181, Medina, OH 44256
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, 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 (PECOS)

Michael Moore 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 Reassignments

2

Medicare enrollment records show Michael Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

West Virginia Psych. Services PLLC
95 mi
Psychiatric/Mental Health
47 WASHINGTON AVE # 168
Wheeling, WV 26003
  • Reassigned Medicare billing, West Virginia enrollment
  • 24 clinicians in this Medicare group
NPI 1407427321 (615) 334-5078
Mental Health Specialty Group PA
388 mi
Mental Health
110 N CORCORAN ST FL 5
Durham, NC 27701
  • Reassigned Medicare billing, Colorado enrollment
  • 160 clinicians in this Medicare group
NPI 1801472634 (323) 205-7088

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 44256 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.42/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality94.28
Improvement Activities40
Cost58.55

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.

SUSAN DORMAN LPN
Licensed Practical Nurse
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
AMY HUFSTEDLER LPN
Licensed Practical Nurse
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
KAYLYNN M PEMBER RN
Nurse Practitioner (Psychiatric/Mental Health)
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
TINA DENISE CLAYTON RN
Nurse Practitioner (Psychiatric/Mental Health)
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
CONITA OAKS LPN
Licensed Practical Nurse
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
HALEY KOZMINSKI
Nurse Practitioner (Psychiatric/Mental Health)
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
ANGELA LAUER BSN, RN
Nurse Practitioner (Psychiatric/Mental Health)
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746
LORI SUE DILORENZO PMHCNS BC
Nurse Practitioner (Psychiatric/Mental Health)
3593 MEDINA RD # 181
MEDINA, OH 44256
Medina County (330) 536-3746

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 Michael Moore's NPI number?

The NPI number for Michael Moore is 1619635117. It was assigned to this individual provider in the NPPES registry on December 1, 2021.

Where is Michael Moore located?

Michael Moore practices at 3593 Medina Rd # 181, Medina, OH 44256. The listed phone number is (330) 536-3746.

What is Michael Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Michael Moore enrolled in Medicare?

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

Which organizations bill Medicare for Michael Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Moore reassigns Medicare benefits to 2 organizations: West Virginia Psych. Services PLLC (Wheeling, WV) and Mental Health Specialty Group PA (Durham, NC). 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 Michael Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Moore accept?

Health plans from CareSource and Select Health list Michael 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 Michael Moore was last updated on April 8, 2022. 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.