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DR. JACOB MOORE MD
NPI 1679320634
Student in an Organized Health Care Education/Training Program in Omaha, NE

Active since May 06, 2024PECOS Enrolled
4400 EMILE ST, OMAHA, NE 68198(402) 552-6007 Get Directions Write a Review

NPPES record last updated: May 6, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jacob Moore Md NPPES

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

DR. JACOB MOORE MD (NPI 1679320634) is an individual student in an organized health care education/training program in Omaha, Nebraska and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679320634
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. JACOB MOORECredential: MD
Location Address4400 EMILE STOmaha, NE 68198-0600
Mailing Address4400 Emile StOmaha, NE 68198-0600
Phone(402) 552-6007
Sole ProprietorNo
Enumeration DateMay 6, 2024
NPPES CertifiedMay 6, 2024
✔ NPI 1679320634 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4400 EMILE ST, Omaha, NE 68198
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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. Jacob Moore Md 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.

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.

NEBRASKA MEDICAL CENTER
Clinical Medical Laboratory
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 552-2000
ALEXIS FRIGYES
Student in an Organized Health Care Education/Training Program
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 559-6000
JACI RAE DIETZ
Student in an Organized Health Care Education/Training Program
4400 EMILE ST
OMAHA, NE 68198
Douglas County (308) 708-0327
AMY LOUISE FREEMAN LSFA
Specialist/Technologist, Other (Surgical Assistant)
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 552-3224
CHELSEA JACOBS
Internal Medicine (Critical Care Medicine)
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 559-6073
KATHERINE MITCHELL
Student in an Organized Health Care Education/Training Program
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 559-4000
EMILY STRUNK DDS
Dentist
4400 EMILE ST
OMAHA, NE 68198
Douglas County (402) 559-6000
CARSON KELLER
Student in an Organized Health Care Education/Training Program
4400 EMILE ST
OMAHA, NE 68198
Douglas County (308) 293-2748

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 Jacob Moore's NPI number?

The NPI number for Jacob Moore is 1679320634. It was assigned to this individual provider in the NPPES registry on May 6, 2024.

Where is Jacob Moore located?

Jacob Moore practices at 4400 Emile St, Omaha, NE 68198. The listed phone number is (402) 552-6007.

What is Jacob Moore's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jacob Moore enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jacob Moore was last updated on May 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.