Mary Kathleen Moore, DO - Medicare Emergency Medicine in Tahlequah, OK

Mary Kathleen Moore, DO is a medicare enrolled "Emergency Medicine - Emergency Medical Services" physician in Tahlequah, Oklahoma. She went to Oklahoma State University College Of Osteopathic Medicine and graduated in 2001 and has 23 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Northeastern Health System and her current practice location is 100 S Bliss Ave, Tahlequah, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (918) 458-3104.

Mary Kathleen Moore is licensed to practice in Oklahoma (license number 3976) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902837776.

Contact Information

Mary Kathleen Moore, DO
100 S Bliss Ave,
Tahlequah, OK 74464-2512
(918) 458-3104
(918) 458-3580



Physician's Profile

Full NameMary Kathleen Moore
GenderFemale
SpecialityEmergency Medicine
Experience23 Years
Location100 S Bliss Ave, Tahlequah, Oklahoma
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mary Kathleen Moore attended and graduated from Oklahoma State University College Of Osteopathic Medicine in 2001
  NPI Data:
  • NPI Number: 1902837776
  • Provider Enumeration Date: 07/06/2006
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 9537063037
  • Enrollment ID: I20040126000884

Medical Identifiers

Medical identifiers for Mary Kathleen Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902837776NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207PE0004XEmergency Medicine - Emergency Medical Services 3976 (Oklahoma)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Northeastern Health SystemTahlequah, OKHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Northeastern Health System145625502595

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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. Mary Kathleen Moore allows following entities to bill medicare on her behalf.
Entity NameNortheastern Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457574170
PECOS PAC ID: 1456255025
Enrollment ID: O20031125000250

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Entity NameAdair County Health Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972780765
PECOS PAC ID: 9638065907
Enrollment ID: O20040224000664

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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. Mary Kathleen 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 AddressPractice Location Address
Mary Kathleen Moore, DO
Po Box 675,
Tahlequah, OK 74465-0675

Ph: (918) 458-5583
Mary Kathleen Moore, DO
100 S Bliss Ave,
Tahlequah, OK 74464-2512

Ph: (918) 458-3104

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Emergency Medicine Doctors in Tahlequah, OK

Stephan M Yost, PA-C
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1400 E Downing St, Tahlequah, OK 74464
Phone: 918-456-0641    
Muhammad Ghias, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1400 E Downing St, Tahlequah, OK 74464
Phone: 918-456-0641    
Dr. William Jack Myers Jr., D.O
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1400 E Downing St, Tahlequah, OK 74464
Phone: 918-456-0641    
Brian William Duignan, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464
Phone: 918-458-3100    Fax: 918-458-3511
Dr. Jason Jasper Ballew, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 1400 E Downing St, Tahlequah, OK 74464
Phone: 918-456-0641    
Dr. Kimberly Jane Collins, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 15100 N 593 Rd, Tahlequah, OK 74464
Phone: 918-822-3302    
Dr. Nanetta Bonita Lowe, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 100 S Bliss Ave, Tahlequah, OK 74464
Phone: 918-458-3100    

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