MARY MOORE
NPI 1780177113
Social Worker - Clinical in Little Rock, AR

Q: What is Mary Moore's NPI number?

The NPI number for Mary Moore is 1780177113. It was assigned to this individual provider in the NPPES registry on June 11, 2018.

Q: What is Mary Moore's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: Is Mary Moore enrolled in Medicare?

No. Mary Moore has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Mary Moore was last updated on October 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 June 11, 2018Opted out of Medicare · through Apr 1, 2028

4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205(501) 690-9773 Get Directions Write a Review

NPPES record last updated: October 22, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 22, 2018, Jun 11, 2018 (2 updates tracked since 2018).

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About Mary Moore NPPES

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

MARY MOORE (NPI 1780177113) is an individual clinical provider in Little Rock, Arkansas, licensed in Arkansas (7925C) and active in the NPI registry since June 2018. She has opted out of Medicare through April 1, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1780177113

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMARY MOORE

Location Address4301 W MARKHAM ST # 783Little Rock, AR 72205-7101

Mailing Address4301 W Markham St # 783Little Rock, AR 72205-7101 · (501) 690-9773

Phone(501) 690-9773

Sole ProprietorNo

Enumeration DateJune 11, 2018

Last NPPES UpdateOctober 22, 20182 updates tracked since enumeration

✔ NPI 1780177113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in AR · 7925C

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

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

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mary Moore has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2024 through April 1, 2028.

Opt-Out Effective DateApril 1, 2024

Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 72205 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

$0.00 typical visit price

range $51.36 – $157.74

Typical copayment $0.00 (range $12.84 – $39.43)

Most-billed visit code NA

Established Patient

$64.56 typical visit price

range $16.16 – $128.77

Typical copayment $16.14 (range $4.04 – $32.19)

Most-billed visit code 99213

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 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNA JANE SCHLESSELMAN OD

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