Nicholas John Eisdell Moore (NPI# 1417905092, PAC ID# 5597701573) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1417905092 |
| PAC ID by PECOS | 5597701573 |
| Professional Enrollment ID | I20100629000311 |
| Full Name | Nicholas John Eisdell Moore |
| Organization Legal Name | PENRAD IMAGING LLC |
| Address |
3050 N Circle Dr Colorado Springs CO 80909-1175 |
| Phone Number | 7195931799 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE |
| Graduation Year | 2000 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 1850387598 |
| Number of Group Practice Members | 25 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 060031 | CENTURA HEALTH-PENROSE ST FRANCIS HEALTH SERVICES |
| Address | Phone | Organization |
|---|---|---|
| 2222 N Nevada Ave, Colorado Springs, CO 80907-6819 | 7195931799 | COLORADO SPRINGS RADIOLOGISTS PC |
| 3050 N Circle Dr, Colorado Springs, CO 80909-1175 | 7195931799 | PENRAD IMAGING LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 89% | |
| MIPS_EC_195_overall | Radiology: Stenosis Measurement in Carotid Imaging Reports | 89% | |
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% | |
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% |
| Organization Legal Name | PENRAD IMAGING LLC |
| Physicians | 24 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Travis Jay Moss | Cardiovascular Disease (cardiology) | Penrad Imaging LLC | 2202 N Nevada Ave, Colorado Springs, CO 80907-6819 |
| John B Campbell | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Jon F Snider | Diagnostic Radiology | Penrad Imaging LLC | 17230 Jackson Creek Pkwy, Suite 160, Monument, CO 80132-7302 |
| Shannon L Daniels | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Derek Scott Bergeson | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Andrzej Wierzbicki Jr. | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Rostislav Medvid | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Lorenzo Orton | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Christopher Scott Peeters | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Douglas R Shaeffer | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Street Address |
3050 N CIRCLE DR |
| City | COLORADO SPRINGS |
| State | CO |
| Zip | 80909-1175 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John B Campbell | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Shannon L Daniels | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Derek Scott Bergeson | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Andrzej Wierzbicki Jr. | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Rostislav Medvid | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Lorenzo Orton | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Christopher Scott Peeters | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Douglas R Shaeffer | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Steven P Jensen | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Eric Robert Weidman | Diagnostic Radiology | Penrad Imaging LLC | 3050 N Circle Dr, Colorado Springs, CO 80909-1175 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karen K Underwood | Psychologist, Clinical | 2815 N Chelton Rd, Colorado Springs, CO 80909-1009 | |
| Cathleen L Oneill | Clinical Social Worker | Dr Horgan and Associates LLC | 2719 N Union Boulevard, Colorado Springs, CO 80909-1145 |
| Catherine Noelle O Shea | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Elizabeth A Gramith | Certified Registered Nurse Anesthetist (crna) | Epix Anesthesia of Colorado Springs, LLC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Courtney Furcini Frerichs | Physician Assistant | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Michael James Baker | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Karin Barbara Cesario | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Bryan Kavanaugh | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Dalette A Carlson | Certified Registered Nurse Anesthetist (crna) | Epix Anesthesia of Colorado Springs, LLC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| William W Lunt | Gastroenterology | Assoc In Gastroenterology, PC | 2940 N Circle Dr, Colorado Springs, CO 80909-1160 |
| Find all physicians in zip 80909 | |||
| City | COLORADO SPRINGS |
| Zip Code | 80909 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | COLORADO SPRINGS + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.