Mrs Lacey Dively Moy, MD - Medicare Family Practice in Springfield, IL

Mrs Lacey Dively Moy, MD is a medicare enrolled "Family Medicine" physician in Springfield, Illinois. She went to Rush Medical College Of Rush University and graduated in 2009 and has 15 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Memorial Physician Services and her current practice location is 3220 Atlanta St, Springfield, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 588-7400.

Mrs Lacey Dively Moy is licensed to practice in Illinois (license number 036129248) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1013144021.

Contact Information

Mrs Lacey Dively Moy, MD
3220 Atlanta St,
Springfield, IL 62707-8801
(217) 588-7400
(217) 588-7439

Map and Direction




Physician's Profile

Full NameMrs Lacey Dively Moy
GenderFemale
SpecialityFamily Practice
Experience15 Years
Location3220 Atlanta St, Springfield, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Lacey Dively Moy attended and graduated from Rush Medical College Of Rush University in 2009
  NPI Data:
  • NPI Number: 1013144021
  • Provider Enumeration Date: 06/17/2009
  • Last Update Date: 05/16/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7618138413
  • Enrollment ID: I20120420000378

Medical Identifiers

Medical identifiers for Mrs Lacey Dively Moy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1013144021NPI-NPPES
036.129248OtherILMD LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 036129248 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Memorial Medical CenterSpringfield, ILHospital
St Johns HospitalSpringfield, ILHospital
Taylorville Memorial HospitalTaylorville, ILHospital
Villa Health Care EastSherman, ILNursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Memorial Physician Services9032005681170

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Lacey Dively Moy allows following entities to bill medicare on her behalf.
Entity NameMemorial Physician Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1417922964
PECOS PAC ID: 9032005681
Enrollment ID: O20040223000454

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lacey Dively Moy is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Lacey Dively Moy, MD
3220 Atlanta St,
Springfield, IL 62707-8801

Ph: (217) 588-7400
Mrs Lacey Dively Moy, MD
3220 Atlanta St,
Springfield, IL 62707-8801

Ph: (217) 588-7400

Reviews and Comments


Family Medicine Doctors in Springfield, IL

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Phone: 217-757-8100    Fax: 217-757-8161

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.