MARY MOORE MD
NPI 1770674640
Radiology - Pediatric Radiology in Little Rock, AR

Active since September 27, 2006PECOS EnrolledAccepts Medicare Assignment
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205(501) 686-8000 Get Directions Write a Review

NPPES record last updated: July 31, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mary Moore Md NPPES

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

MARY MOORE MD (NPI 1770674640) is an individual pediatric radiology provider in Little Rock, Arkansas, licensed in Arkansas (E-2215) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS and is a graduate of Creighton University School Of Medicine (1992).

NPPES Registry Identity

NPI1770674640
Entity TypeIndividualFemale
Primary Taxonomy2085P0229X
Provider Legal NameMARY MOORECredential: MD
Location Address4301 W MARKHAM ST # 783Little Rock, AR 72205-7101
Mailing Address4301 W Markham St # 783Little Rock, AR 72205-7101 · (501) 686-8000
Sole ProprietorNo
Medical School CMSCreighton University School Of MedicineGraduated 1992
Enumeration DateSeptember 27, 2006
Last NPPES UpdateJuly 31, 2007
NPI 1770674640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Pediatric RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085P0229X
License Licensed in AR · E-2215
Definition

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

4301 W MARKHAM ST # 783, Little Rock, AR 72205

Other Identifiers 2

Medicare UPING59635
Medicare PIN5L166

Accepted Insurance

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

Mary Moore Md 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 ID2264455724
PECOS Enrollment IDI20060110001155
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.

Neurological Surgery
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Radiology (Diagnostic Radiology)
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Surgery
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Psychiatry & Neurology (Psychiatry)
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Physician Assistant (Medical)
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Internal Medicine (Cardiovascular Disease)
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Radiology (Body Imaging)
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205
Physical Medicine & Rehabilitation
4301 W MARKHAM ST # 783
LITTLE ROCK, AR 72205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770674640, enumerated as an "individual" on September 27, 2006.

The provider is located at 4301 W MARKHAM ST # 783 LITTLE ROCK, AR 72205 and the phone number is (501) 686-8000.

Radiology with taxonomy code 2085P0229X and a focus in Pediatric Radiology.

The provider might be accepting Accepts: Ambetter from Arkansas Health & Wellness, Ambetter. Please consult your insurance carrier or call the provider to verify.