MARY MOORE MD
NPI 1770674640
Radiology - Pediatric Radiology in Little Rock, AR
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
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
3Medicare enrollment records show Mary Moore reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Little Rock, AR 72205
- Reassigned Medicare billing, Arkansas enrollment
- Also billed through NPI 1043372220 (Arkansas)
- 1,246 clinicians in this Medicare group
Little Rock, AR 72202
- Reassigned Medicare billing, Arkansas enrollment
- 653 clinicians in this Medicare group
Little Rock, AR 72202
- Reassigned Medicare billing, Arkansas enrollment
- 944 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.
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.
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
LITTLE ROCK, AR 72205
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 1770674640. It was assigned to this individual provider in the NPPES registry on September 27, 2006.
Where is Mary Moore located?
Mary Moore practices at 4301 W Markham St # 783, Little Rock, AR 72205. The listed phone number is (501) 686-8000.
What is Mary Moore's specialty?
The primary specialty registered for this NPI is Radiology, specializing in Pediatric Radiology, with taxonomy code 2085P0229X.
Is Mary Moore enrolled in Medicare?
Yes. Mary Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
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 3 organizations: University Of Arkansas For Medical Sciences (Little Rock, AR), Arkansas Childrens Professional Services Organization LLC (Little Rock, AR) and Arkansas Childrens Hospital (Little Rock, AR). 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 Arkansas Blue Cross and Blue Shield, Health Advantage and Octave 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 July 31, 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.
# Mary Moore, MD · NPI 1770674640
Pediatric Radiology physician in Little Rock, Arkansas. Individual provider, active in the CMS NPPES registry since September 27, 2006.
## Identity
- **NPI:** 1770674640 (Entity type: Individual)
- **Enumerated:** September 27, 2006
- **Primary specialty:** Radiology - Pediatric Radiology · taxonomy 2085P0229X
- **State license:** E-2215 (Arkansas)
- **Sole proprietor:** No
## Practice location
- **Address:** 4301 W MARKHAM ST # 783, Little Rock, AR 72205-7101
- **Phone:** (501) 686-8000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): University Of Arkansas For Medical Sciences (NPI 1326341488, Little Rock, AR); Arkansas Childrens Professional Services Organization LLC (NPI 1629889464, Little Rock, AR); Arkansas Childrens Hospital (NPI 1598773079, Little Rock, AR) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Creighton University School Of Medicine, class of 1992
## Record status
- **NPPES last updated:** July 31, 2007
- **Other identifiers:** Medicare UPIN G59635; Medicare PIN 5L166
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Source: [NPI Profile](https://npiprofile.com/npi/1770674640) · Data from the CMS NPPES public registry.