Alexis Lynn Moore, FNP-C is a medicare enrolled "Nurse Practitioner" in N Fond Du Lac, Wisconsin. Her current practice location is
723 Park Ridge Ln, N Fond Du Lac, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 926-8600.
Alexis Lynn Moore is licensed to practice in Wisconsin (license number 13789-33) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1275213076.
Provider's Profile
| Full Name | Alexis Lynn Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 723 Park Ridge Ln, N Fond Du Lac, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1275213076
- Provider Enumeration Date: 07/18/2023
- Last Update Date: 02/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 3274996277
- Enrollment ID: I20230823003414
Medical Identifiers
Medical identifiers for Alexis Lynn Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1275213076 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 13789-33 (Wisconsin) | 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. Alexis Lynn Moore allows following entities to bill medicare on her behalf.
| Entity Name | Agnesian Healthcare Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346228541
PECOS PAC ID: 1658289624
Enrollment ID: O20031104000263 |
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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. Alexis Lynn 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 |
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Alexis Lynn Moore, FNP-C
1808 W Beltline Hwy,
Madison, WI 53713-2334
Ph: (608) 280-4647 | Alexis Lynn Moore, FNP-C
723 Park Ridge Ln,
N Fond Du Lac, WI 54937-1385
Ph: (920) 926-8600 |
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