Dr Mary Ellen Moore, PH D in Chicago, IL - Medicare Psychologist Provider

Dr Mary Ellen Moore, PH D is a medicare enrolled "Psychologist - Clinical" provider in Chicago, Illinois. Her current practice location is 2648 W Pershing Rd, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (312) 806-1885.

Dr Mary Ellen Moore is licensed to practice in Illinois (license number 071002095) 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 1487735940.

Contact Information

	Dr Mary Ellen Moore, PH D
	2648 W Pershing Rd, Chicago, IL 60632-1629
	(312) 806-1885
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Mary Ellen Moore
Gender	Female
Speciality	Psychologist - Clinical
Location	2648 W Pershing Rd, Chicago, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487735940
Provider Enumeration Date: 10/18/2006
Last Update Date: 05/20/2020

Medicare PECOS Information:

PECOS PAC ID: 6709044076
Enrollment ID: I20120220000292

Medical Identifiers

Medical identifiers for Dr Mary Ellen Moore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487735940	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	071002095 (Illinois)	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. Dr Mary Ellen Moore allows following entities to bill medicare on her behalf.

Entity Name	The Circle El Circulo Of The Society Of Helpers
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285181438 PECOS PAC ID: 0042592818 Enrollment ID: O20170131002372

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. Dr Mary Ellen 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
Dr Mary Ellen Moore, PH D 2648 W Pershing Rd, Chicago, IL 60632-1629 Ph: (312) 806-1885	Dr Mary Ellen Moore, PH D 2648 W Pershing Rd, Chicago, IL 60632-1629 Ph: (312) 806-1885

Reviews and Comments

Psychologist in Chicago, IL

Dr. Pamela Daley, PSYD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 30 N Michigan Ave, Suite 1510, Chicago, IL 60602 Phone: 773-615-9477
Dr. Marilyn Sue Johnson, PH.D Psychologist Medicare: Not Enrolled in Medicare Practice Location: 233 E Erie St, Chicago, IL 60611 Phone: 312-337-0374 Fax: 630-762-9978
Dr. Aisha Kazi, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 233 E Erie St, Suite 407, Chicago, IL 60611 Phone: 305-804-5842
Dr. Amber D Bauer-gambla, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 25 East Washington Street, Suite 1601, Chicago, IL 60602 Phone: 312-720-8008
Dr. Rachel Catherine Tercek, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1653 W. Congress Parkway, Chicago, IL 60612 Phone: 847-933-9339
Ms. Michelle T Frank, PSY.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1448 N Milwaukee Ave, Suite 201, Chicago, IL 60622 Phone: 773-486-4617 Fax: 773-486-4936
Dr. Rae Watkins, PSYD Psychologist Medicare: Accepting Medicare Assignments Practice Location: 1519 W Irving Park Rd Ste 1, Chicago, IL 60613 Phone: 773-600-7580

Dr Mary Ellen Moore, PH D - Medicare Psychologist in Chicago, IL