JACQUELINE P. MOORE M.D.
NPI 1679620488
Pediatrics in Southfield, MI

Q: What is Jacqueline Moore's NPI number?

The NPI number for Jacqueline Moore is 1679620488. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Q: What is Jacqueline Moore's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Moore was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since January 04, 2007PECOS Enrolled

HENRY FORD HEALTH SYSTEM, 22777 W. ELEVEN MILE RD, SOUTHFIELD, MI 48034(248) 358-0722(248) 358-8658 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jacqueline P. Moore M.d. NPPES

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

JACQUELINE P. MOORE M.D. (NPI 1679620488) is an individual pediatrics provider in Southfield, Michigan, licensed in Michigan (4301038170) and active in the NPI registry since January 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679620488

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameJACQUELINE P. MOORECredential: M.D.

Location AddressHENRY FORD HEALTH SYSTEM, 22777 W. ELEVEN MILE RDSouthfield, MI 48034

Mailing AddressHenry Ford Health System, 22777 W. Eleven Mile RdSouthfield, MI 48034 · (248) 358-0722

Phone(248) 358-0722

Fax(248) 358-8658

Sole ProprietorNo

Enumeration DateJanuary 4, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1679620488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 4301038170

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

HENRY FORD HEALTH SYSTEM, Southfield, MI 48034

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Other Identifiers 3

OtherJM038170Commercial-commercial Number

Medicare UPINE00455

OtherJM038170Champus-champus

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline P. Moore M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48034 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

$90.76 typical visit price

range $58.04 – $177.36

Typical copayment $22.69 (range $14.51 – $44.34)

Most-billed visit code 99203

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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.

TERRY R. GORDON M.D.

Internal Medicine

HENRY FORD HEALTH SYSTEM, 22777 W. ELEVEN MILE RD
SOUTHFIELD, MI 48034

Oakland County (248) 358-0722

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 Jacqueline Moore's NPI number?

The NPI number for Jacqueline Moore is 1679620488. It was assigned to this individual provider in the NPPES registry on January 4, 2007.

Where is Jacqueline Moore located?

Jacqueline Moore practices at Henry Ford Health System 22777 W. Eleven Mile Rd, Southfield, MI 48034. The listed phone number is (248) 358-0722.

What is Jacqueline Moore's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jacqueline Moore enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jacqueline Moore was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.