Justin Moore, MD
NPI 1104679059 · Student in an Organized Health Care Education/Training Program · Chicago, IL
Enrolled with Medicare as Order and Referring Only - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Justin Moore, MD is a Student in an Organized Health Care Education/Training Program provider in Chicago, IL (NPI 1104679059).
Provider details
- NPI number
- 1104679059
- Entity type
- Individual
- Primary specialty
- Student in an Organized Health Care Education/Training ProgramStudent, Health Care
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Student, Health Care
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2024-04-10
- Last updated
- 2025-05-11
- Certified
- 2025-05-11
Frequently asked questions
- What is Justin Moore's NPI number?
- Justin Moore's National Provider Identifier (NPI) is 1104679059, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Justin Moore's specialty?
- Justin Moore is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program (Student, Health Care).
- Where is Justin Moore located?
- Justin Moore's practice location on file with NPPES is 1901 W Harrison St, Chicago, IL 60612-3714.
- What is Justin Moore's phone number?
- The practice phone number listed in the NPPES registry for Justin Moore is (312) 864-6000.
- Does Justin Moore accept Medicare?
- Justin Moore is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Justin Moore's NPI active?
- Yes — Justin Moore's NPI (1104679059) is active in the NPPES registry as of the last update on 2025-05-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.