Thomas C Moore, MD in Vicksburg, MS

Thomas C Moore, MD is a medicare enrolled "Pediatrics" physician in Vicksburg, Mississippi. His current practice location is 1115 N Frontage Rd, Vicksburg, Mississippi. You can reach out to his office (for appointments etc.) via phone at (601) 634-8790.

Thomas C Moore is licensed to practice in Mississippi (license number 14614) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184655060.

Contact Information

	Thomas C Moore, MD
	1115 N Frontage Rd, Vicksburg, MS 39180-5102
	(601) 634-8790
	Not Available

Map and Direction

Physician's Profile

Full Name	Thomas C Moore
Gender	Male
Speciality	Pediatrics
Location	1115 N Frontage Rd, Vicksburg, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184655060
Provider Enumeration Date: 07/06/2006
Last Update Date: 08/05/2008

Medicare PECOS Information:

PECOS PAC ID: 1355474164
Enrollment ID: I20100730000519

Medical Identifiers

Medical identifiers for Thomas C Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184655060	NPI	-	NPPES
00115748	Medicaid	MS
5699557	Other	MS	AETNA
1693804	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	14614 (Mississippi)	Primary

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. Thomas C Moore allows following entities to bill medicare on his behalf.

Entity Name	Vicksburg Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790711158 PECOS PAC ID: 5890696330 Enrollment ID: O20040116000738

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. Thomas C Moore 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 Address	Practice Location Address
Thomas C Moore, MD 1115 N Frontage Rd, Vicksburg, MS 39180-5102 Ph: (601) 634-8790	Thomas C Moore, MD 1115 N Frontage Rd, Vicksburg, MS 39180-5102 Ph: (601) 634-8790

Reviews and Comments

Pediatrics Doctors in Vicksburg, MS

Lisa D Fairchild, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000
Dr. Izzeddin Kamelmaz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-6001
Constance Phylea Barnes-woods, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-3391 Fax: 601-883-3318
Elizabeth N Roy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000
Geri L Weiland, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000
Gordon W Sluis, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1115 N Frontage Rd, Vicksburg, MS 39180 Phone: 601-634-8790

Thomas C Moore, MD - Medicare Pediatrics in Vicksburg, MS