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ALICE LOUISE MOON
NPI 1962099887
Family Medicine in Oklahoma City, OK

Active since December 26, 2020PECOS Enrolled
2605 NW 11TH ST, OKLAHOMA CITY, OK 73107(405) 514-5253 Get Directions Write a Review

NPPES record last updated: August 25, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alice Louise Moon NPPES

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

ALICE LOUISE MOON (NPI 1962099887) is an individual family medicine provider in Oklahoma City, Oklahoma, licensed in Oregon (PG225203) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962099887
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameALICE LOUISE MOON
Location Address2605 NW 11TH STOklahoma City, OK 73107-5413
Mailing Address2605 Nw 11th StOklahoma City, OK 73107-5413
Phone(405) 514-5253
Sole ProprietorNo
Enumeration DateDecember 26, 2020
Last NPPES UpdateAugust 25, 2025
NPPES CertifiedAugust 25, 2025
✔ NPI 1962099887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in OR · PG225203
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
2605 NW 11TH ST, Oklahoma City, OK 73107
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alice Louise Moon 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 73107 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
$82.46 typical visit price
range $53.00 – $162.61
Typical copayment $20.61 (range $13.25 – $40.65)
Most-billed visit code 99203
Established Patient
$94.27 typical visit price
range $16.68 – $132.40
Typical copayment $23.56 (range $4.17 – $33.10)
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.

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 Alice Moon's NPI number?

The NPI number for Alice Moon is 1962099887. It was assigned to this individual provider in the NPPES registry on December 26, 2020.

Where is Alice Moon located?

Alice Moon practices at 2605 NW 11th St, Oklahoma City, OK 73107. The listed phone number is (405) 514-5253.

What is Alice Moon's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Alice Moon enrolled in Medicare?

Yes. Alice Moon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alice Moon was last updated on August 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.