| Pamela M Moore, NP | |
|
611 W. Park St., Cardiology, Urbana, IL 61801-2500 | |
| (217) 904-7000 | |
| (217) 904-7742 |
| Full Name | Pamela M Moore |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 29 Years |
| Location | 611 W. Park St., Urbana, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881701308 | NPI | - | NPPES |
| 103086 | Other | MC COCHISE | |
| 300051634 | Other | MARICOPA FOUND | |
| 448664 | Other | MERCY CARE | |
| 103087 | Other | AZ | RR MC PIN |
| 103087 | Other | MC PIMA | |
| 1Z1408 | Other | INTERGROUP HEALTHNET | |
| 300051634 | Other | HUMANA | |
| 448664 | Other | AHCCCS | |
| AZ0819900 | Other | AZ | BCBS |
| 300051634 | Other | AZ | HEALTH PLAN AHP |
| 300051634 | Other | CIGNA | |
| 102542 | Other | AZ | RR MC GRP |
| 103086 | Other | AZ | RR MC PIN |
| 500005593 | Other | TRAVELERS MC | |
| 300051634 | Other | AETNA | |
| 448664 | Other | INDIAN HEALTH | |
| 448664 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0129X | Surgery - Vascular Surgery | RN81005 (Arizona) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 209-006880 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| The Carle Foundation Hospital | Urbana, IL | Hospital |
| Kirby Medical Center | Monticello, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Carle Health Care Incorporated | 3577515774 | 912 |
| Entity Name | Prairie Cardiovascular Consultants Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982714218 PECOS PAC ID: 3173435880 Enrollment ID: O20031103000090 |
| Entity Name | Carle Health Care Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Pamela M Moore, NP 611 W. Park St., Bwpc, Urbana, IL 61801-2500 Ph: (217) 383-6792 | Pamela M Moore, NP 611 W. Park St., Cardiology, Urbana, IL 61801-2500 Ph: (217) 904-7000 |