Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710462734 Individual Practitioner Male Practitioner

Andrew Marc Moore

Physician Assistant • Beavercreek, OH

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Andrew Moore is a certified Physician Assistant practicing in Beavercreek, OH. With approximately 8 years of clinical experience since graduating from Lincoln Memorial University Medical Department in 2018, Andrew Moore delivers high-quality medical care to the local community at 3535 PENTAGON BLVD.

Andrew Moore is affiliated with Kettering Independent Medical Group Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include critical care, first, initial hospital care with moderate level of medical decision making, if using time, at least, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

3535 Pentagon Blvd

Beavercreek, OH 454311705

Telephone 9377024024
Fax 9377024035
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Lincoln Memorial University Medical Department

Graduation Year

2018

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Beavercreek, OH

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
8 Yrs +0.2 yrs vs City Avg
City Avg: 7.8 Yrs
State Avg: 9.7 Yrs
Regional Practice Density
24 Specialists

Practicing in Beavercreek, OH (5376 Statewide)

Telehealth Adoption Rate
12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
68.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Moore (8 Years) 8 Yrs
Beavercreek Specialty Average (7.8 Years) 7.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99291 Critical care, first 30-74 minutes
16 16 $479.00 $173.30
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
12 12 $528.00 $140.43

Medical Specialties & State Licenses

CMS Verified: 2021-01-12
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OH 50.005821RX

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

State License TN 3688

Definition to come...

Hospital & Practice Group Affiliations

Kettering Independent Medical Group Inc

3535 Pentagon Park Blvd, Dayton, OH 454311705

Phone: 9374902264

Kettering Independent Medical Group Inc

3535 Pentagon Blvd, Beavercreek, OH 454311705

Kettering Independent Medical Group Inc

4441 Far Hills Ave, Kettering, OH 454292405

Phone: 9372987751

Kettering Independent Medical Group Inc

4403 Far Hills Ave, Kettering, OH 454292405

Phone: 9374335309

Secondary Practice Locations

2105 Sherbrooke Ln

Nashville, TN 372117029

Phone: 8657768490

Practice Associates & Co-Workers

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

2 Associated Practitioners
Raeanne Fondriest , AG-ACNP

Nurse Practitioner - Acute Care

NPI 1194105692

Adult-Gerontology Acute Care Nurse Practitioner

Courtney Pemberton , APRN

Nurse Practitioner - Acute Care

NPI 1932701604

Advanced Practice Registered Nurse

Career & Practice History Timeline

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

8 Historical Events
📍
Updated Practice Location January 12, 2021

Registered at 3535 PENTAGON BLVD, BEAVERCREEK, OH 454311705 (Tel: 9377024024)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2019

Physician Assistant (License #50.005821RX in OH)

NPI Profile Active September 25, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location September 25, 2018

Registered at 2105 SHERBROOKE LN, NASHVILLE, TN 372117029 (Tel: 8657768490)

📍
Updated Business Mailing Address September 25, 2018

Registered at 2105 SHERBROOKE LN, NASHVILLE, TN 372117029 (Tel: 8657768490)

👤
Provider Name / Credentials Updated September 25, 2018

Recorded as ANDREW MOORE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2018

Physician Assistant (License #3688 in TN)

🟢
Initial NPI Registration & Enumeration September 25, 2018

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: 1710462734
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 25, 2018
Last Update: January 12, 2021
Sole Proprietor: No

Mailing Address

2105 Sherbrooke Ln

Nashville, TN 372117029

Phone: 8657768490

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.