| Mr Bradley J Moore, MD | |
|
901 Heartland Road, Plaza 2 Suite 1800, St. Joseph, MO 64506 | |
| (816) 232-8877 | |
| (816) 232-0307 |
| Full Name | Mr Bradley J Moore |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 17 Years |
| Location | 901 Heartland Road, Plaza 2 Suite 1800, St. Joseph, Missouri |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295963783 | NPI | - | NPPES |
| 2009015677 | Other | MO | STATE TEMPORARY LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 2014009227 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Carroll County Memorial Hospital | Carrollton, MO | Hospital |
| Wright Memorial Hospital | Trenton, MO | Hospital |
| Mosaic Life Care At St Joseph | Saint joseph, MO | Hospital |
| Hiawatha Community Hospital | Hiawatha, KS | Hospital |
| Mosaic Medical Center Albany | Albany, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carroll County Memorial Hospital | 2860485638 | 65 |
| Phoenix Urology Of St Joseph Inc | 0840224291 | 5 |
| Entity Name | Saint Luke's Hospital Of Trenton |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841274057 PECOS PAC ID: 3971495532 Enrollment ID: O20040327000339 |
| Entity Name | Carroll County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528067113 PECOS PAC ID: 2860485638 Enrollment ID: O20040407000120 |
| Entity Name | Phoenix Urology Of St Joseph Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679674048 PECOS PAC ID: 0840224291 Enrollment ID: O20050924000143 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Bradley J Moore, MD 901 Heartland Road, Plaza 2 Suite 1800, St. Joseph, MO 64506 Ph: (816) 232-8877 | Mr Bradley J Moore, MD 901 Heartland Road, Plaza 2 Suite 1800, St. Joseph, MO 64506 Ph: (816) 232-8877 |