MARY A MOORE NP
NPI 1972598753
Nurse Practitioner - Family in West Bend, WI
About Mary A Moore Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY A MOORE NP (NPI 1972598753) is an individual family provider in West Bend, Wisconsin, licensed in Wisconsin (1744-33) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary A Moore Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mary Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Waukesha, WI 53186
- Reassigned Medicare billing, Wisconsin enrollment
- 191 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 53095 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 1972598753. It was assigned to this individual provider in the NPPES registry on September 16, 2005.
Where is Mary Moore located?
Mary Moore practices at 3801 Decorah Rd, West Bend, WI 53095. The listed phone number is (704) 529-6161.
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 organization bills Medicare for Mary Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Moore reassigns Medicare benefits to Oak Medical Sc (Waukesha, WI). The 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.
When was this NPI record last updated?
The NPPES record for Mary Moore was last updated on May 6, 2024. 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 A Moore, NP · NPI 1972598753
Family physician in West Bend, Wisconsin. Individual provider, active in the CMS NPPES registry since September 16, 2005.
## Identity
- **NPI:** 1972598753 (Entity type: Individual)
- **Enumerated:** September 16, 2005
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 1744-33 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 3801 DECORAH RD, West Bend, WI 53095-9597
- **Phone:** (704) 529-6161
## 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:** Oak Medical Sc (NPI 1669910345, Waukesha, WI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 6, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1972598753) · Data from the CMS NPPES public registry.