MARY MAUDEANA MOORE CNP
NPI 1689077927
Nurse Practitioner - Family in Minot Afb, ND
About Mary Maudeana Moore Cnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY MAUDEANA MOORE CNP (NPI 1689077927) is an individual family provider in Minot Afb, North Dakota, licensed in Alabama (1-117717) and active in the NPI registry since October 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Muskogee.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Maudeana Moore Cnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Mary Moore reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Florence, AL 35630
- Reassigned Medicare billing, Alabama enrollment
- 123 clinicians in this Medicare group
Russellville, AL 35653
- Reassigned Medicare billing, Alabama enrollment
- 138 clinicians in this Medicare group
Cullman, AL 35055
- Reassigned Medicare billing, Alabama enrollment
- 38 clinicians in this Medicare group
Birmingham, AL 35235
- Reassigned Medicare billing, Alabama enrollment
- 66 clinicians in this Medicare group
Princess Anne, MD 21853
- Reassigned Medicare billing, Alabama enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 2
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 58705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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.
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 Moore's NPI number?
The NPI number for Mary Moore is 1689077927. It was assigned to this individual provider in the NPPES registry on October 1, 2014.
Where is Mary Moore located?
Mary Moore practices at 10 Missile Ave, Minot Afb, ND 58705. The listed phone number is (701) 723-5190.
What is Mary Moore's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Mary Moore enrolled in Medicare?
Yes. Mary Moore is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mary Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Moore reassigns Medicare benefits to 5 organizations: Advantage Family Care Inc (Florence, AL), Russellville Hospital Inc (Russellville, AL), Alabama Mso LLC (Cullman, AL), Eastern Hospital Medicine PC (Birmingham, AL) and Medical Director Services PC (Princess Anne, MD). 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 Mary Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mary Moore accept?
Health plans from Blue Cross and Blue Shield of Alabama list Mary 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 Mary Moore was last updated on November 6, 2023. 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.
# Mary Maudeana Moore, CNP · NPI 1689077927
Family physician in Minot Afb, North Dakota. Individual provider, active in the CMS NPPES registry since October 1, 2014.
## Identity
- **NPI:** 1689077927 (Entity type: Individual)
- **Enumerated:** October 1, 2014
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1-117717 (Alabama)
- **Sole proprietor:** No
## Practice location
- **Address:** 10 MISSILE AVE, Minot Afb, ND 58705-5003
- **Phone:** (701) 723-5190 · **Fax:** (701) 723-5391
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Advantage Family Care Inc (NPI 1023447943, Florence, AL); Russellville Hospital Inc (NPI 1780232314, Russellville, AL); Alabama Mso LLC (NPI 1740073980, Cullman, AL); Eastern Hospital Medicine PC (NPI 1104859123, Birmingham, AL); Medical Director Services PC (NPI 1871955807, Princess Anne, MD) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 6, 2023
- **Other identifiers:** Medicaid 200558940A (OK)
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Source: [NPI Profile](https://npiprofile.com/npi/1689077927) · Data from the CMS NPPES public registry.