Martin Ryan Moon (NPI# 1174516934, PAC ID# 9931133006) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1174516934 |
| PAC ID by PECOS | 9931133006 |
| Professional Enrollment ID | I20050920000055 |
| Full Name | Martin Ryan Moon |
| Organization Legal Name | SUMMIT MEDICAL GROUP, INC. |
| Address |
20 Medical Village Dr Edgewood KY 41017-5401 |
| Phone Number | 8595785880 |
| Gender | M |
| Credential | MD |
| Medical School | CREIGHTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialties | THORACIC SURGERY |
| Group Practice PAC ID | 2163326240 |
| Number of Group Practice Members | 511 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180045 | ST ELIZABETH FLORENCE |
| 180035 | ST ELIZABETH EDGEWOOD |
| 180001 | ST ELIZABETH FT THOMAS |
| 181311 | ST ELIZABETH GRANT |
| Address | Phone | Organization |
|---|---|---|
| 20 Medical Village Dr, Edgewood, KY 41017-5401 | 8595785880 | SUMMIT MEDICAL GROUP, INC. |
| 7370 Turfway Rd, Florence, KY 41042-4895 | 8592125125 | SUMMIT MEDICAL GROUP, INC. |
| Organization Legal Name | SUMMIT MEDICAL GROUP, INC. |
| Physicians | 487 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Caroline Elmer-lyon | Urology | Summit Medical Group, Inc. | 610 Medical Village Dr, Edgewood, KY 41017-3416 |
| James Schack | Family Medicine | Summit Medical Group, Inc. | 79 Country Club Dr, Butler, KY 41006-8704 |
| Balaji Kalyanaraman | Urology | Summit Medical Group, Inc. | 7370 Turfway Rd, Florence, KY 41042-4895 |
| Abraham Llapitan Tacang | Rheumatology | Summit Medical Group, Inc. | 651 Centre View Boulvard, Crestview Hills, KY 41017-5419 |
| Rani L. Clark | Nurse Practitioner | Summit Medical Group, Inc. | 2885 Alexandria Way, Highland Heights, KY 41076-1511 |
| Gabriel Ymalay | Internal Medicine | Summit Medical Group, Inc. | 135 Courthouse Xing, Independence, KY 41051-2509 |
| Ashley Nicole Minton | Family Medicine | Summit Medical Group, Inc. | 300 Commerical Circle, Alexandria, KY 41001-0001 |
| Saadeddine Dughman | Cardiovascular Disease (cardiology) | Summit Medical Group, Inc. | 900 Medical Village Dr, Edgewood, KY 41017-3422 |
| James Michael Morrow | Podiatry | Summit Medical Group, Inc. | 525 Alexandria Pike, Suite 230, Southgate, KY 41071-3243 |
| Brandon A Cowan | Hospitalist | Summit Medical Group, Inc. | 1 Medical Village Dr, Edgewood, KY 41017-3403 |
| Street Address |
20 MEDICAL VILLAGE DR |
| City | EDGEWOOD |
| State | KY |
| Zip | 41017-5401 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kaitlin Marie Pielage | Nurse Practitioner | St Elizabeth Medical Center, Inc | 20 Medical Village Dr, Edgewood, KY 41017-5401 |
| Vidya Devarajan | Infectious Disease | Infectious Disease Consultants Inc | 20 Medical Village Dr, Suite 355, Edgewood, KY 41017-5414 |
| Maria Reid | Obstetrics/gynecology | Seven Hills Ob/gyn Associates Inc | 20 Medical Village Dr, Edgewood, KY 41017-5401 |
| Barbara R Mackey | Qualified Audiologist | Head and Neck Surgery Associates, Psc | 20 Medical Village Dr, Suite 268, Edgewood, KY 41017-5411 |
| Kendall R Diebold | Nurse Practitioner | St Elizabeth Medical Center, Inc | 20 Medical Village Dr, Edgewood, KY 41017-5401 |
| John C Peterson | Internal Medicine | Infectious Disease Consultants Inc | 20 Medical Village Dr, Suite 355, Edgewood, KY 41017-5414 |
| Carla A. Kurtz | Qualified Audiologist | Head and Neck Surgery Associates, Psc | 20 Medical Village Dr, Suite 268, Edgewood, KY 41017-5411 |
| Alyssa Anne Mcdonald | Nurse Practitioner | St Elizabeth Medical Center, Inc | 20 Medical Village Dr, Edgewood, KY 41017-5401 |
| Emily M Woeste | Obstetrics/gynecology | Seven Hills Ob/gyn Associates Inc | 20 Medical Village Dr, Edgewood, KY 41017-5401 |
| Nathan Wiebracht | Otolaryngology | Head and Neck Surgery Associates, Psc | 20 Medical Village Dr, Suite 268, Edgewood, KY 41017-5411 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Latasha M Swafford | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Erina T Emerson | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Dawna M Kennedy | Nurse Practitioner | Take Care Health Kentucky, P.s.c. | 606 Buttermilk Pike, Crescent Springs, KY 41017-1302 |
| Kelly Reitzes | Optometry | Wing Eyecare, Inc. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Paul T Bertram | Optometry | Bertram Eyecare, P.s.c. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Jamie Daniels Bertram | Optometry | Bertram Eyecare, P.s.c. | 705 Buttermilk Pike, Suite 100, Crescent Springs, KY 41017-1318 |
| Gena Grigson | Clinical Social Worker | 2521 Anderson Rd A, Crescent Springs, KY 41017-1521 | |
| Geraldine E Elliott | Clinical Social Worker | 2521 Anderson Rd A, Crescent Springs, KY 41017-1521 | |
| Merle C Helgeson | Chiropractic | 570 Buttermilk Pike, Crescent Springs, KY 41017-1635 | |
| Monica K Sullivan | Family Medicine | Christ Hospital Medical Associates, II LLC | 2156 Chamber Ctr Dr, Lakeside Park, KY 41017-1669 |
| Find all physicians in zip 41017 | |||
| City | EDGEWOOD |
| Zip Code | 41017 |
| Specialty | GENERAL SURGERY |
| City + Specialty | EDGEWOOD + GENERAL SURGERY |
Please comment or provide details below to improve the information on Martin Ryan Moon.
| 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.