Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1306064860 Individual Practitioner Male Practitioner

Dr. Michael Kirk Moore , MD, PC

Surgery - Plastic and Reconstructive Surgery • Idaho Falls, ID

Professional Overview & Biography Verified Profile Summary

Dr. Michael Moore, MD, PC is a registered healthcare professional specializing in Surgery - Plastic and Reconstructive Surgery in Idaho Falls, ID. Practice services are available at 2860 CHANNING WAY under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2860 Channing Way
Suite 213

Idaho Falls, ID 834047531

Telephone 2085521406
Fax 2085521416
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery - Plastic and Reconstructive Surgery in Idaho Falls, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 24.4 Yrs
Regional Practice Density
2 Specialists

Practicing in Idaho Falls, ID (13 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Surgery - Plastic and Reconstructive Surgery Primary Specialty

NUCC Taxonomy Code: 2086S0122X

State License ID M-8270

A surgeon who specializes in plastic and reconstructive surgery.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medical License, Id
M-8270 (ID)
Commercial Insurance / Payer ID Ut Medical License
5959620-1205 (UT)
Commercial Insurance / Payer ID Wy St Board Of Pharmacy
58MKM02 (WY)
Commercial Insurance / Payer ID Ut St Board Of Pharmacy
5959620-8905 (UT)
Commercial Insurance / Payer ID Wy Medical License
6687A (WY)
Commercial Insurance / Payer ID Id St Board Of Pharmacy
CS9201 (ID)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Dr. Shannon Jenkins , DO

Pediatrics - Neonatal-Perinatal Medicine

NPI 1023083680

Doctor of Osteopathic Medicine (D.O.)

Brandi Smith , APRN-CNP

Nurse Practitioner - Family

NPI 1114447406

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Emily Cowles , RD, LD

Dietitian, Registered

NPI 1205125259

Registered Dietitian, Licensed Dietitian

Dr. Sarah Vlach , MD

Physical Medicine & Rehabilitation

NPI 1326002221

Doctor of Medicine (M.D.)

NPI 1447368758

Doctor of Medicine (M.D.)

Dr. Ronald Arbon , MD

Family Medicine - Adult Medicine

NPI 1528156577

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 2860 CHANNING WAY, SUITE 213, IDAHO FALLS, ID 834047531 (Tel: 2085521406)

📍
Updated Business Mailing Address July 08, 2007

Registered at PO BOX 1769, IDAHO FALLS, ID 834031769 (Tel: 2085521406)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL MOORE, M.D., P.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Surgery (License #M-8270 in ID)

🟢
Initial NPI Registration & Enumeration April 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1306064860
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2007
Last Update: March 07, 2023
Sole Proprietor: Yes

Mailing Address

Po Box 1769

Idaho Falls, ID 834031769

Phone: 2085521406

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.