Amanda D Moore, FNP is a medicare enrolled "Nurse Practitioner" in Idalou, Texas. Her current practice location is
113 Walnut St, Idalou, Texas. You can reach out to her office (for appointments etc.) via phone at
(806) 892-2537.
Amanda D Moore is licensed to practice in Texas (license number AP119568) 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 1497065619.
Provider's Profile
| Full Name | Amanda D Moore |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 113 Walnut St, Idalou, Texas |
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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: 1497065619
- Provider Enumeration Date: 10/21/2010
- Last Update Date: 12/02/2021
Medicare PECOS Information:
- PECOS PAC ID: 8325227259
- Enrollment ID: I20110125000594
Medical Identifiers
Medical identifiers for Amanda D Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497065619 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 709372 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | AP119568 (Texas) | 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. Amanda D Moore allows following entities to bill medicare on her behalf.
| Entity Name | Texas Tech University Health Sciences Center Lubbock |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063461358
PECOS PAC ID: 4385549674
Enrollment ID: O20110318000468 |
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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. Amanda D 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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Amanda D Moore, FNP
3601 4th St,
Lubbock, TX 79430-8312
Ph: (806) 743-2373 | Amanda D Moore, FNP
113 Walnut St,
Idalou, TX 79329-4003
Ph: (806) 892-2537 |
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