Ethan Thomas Moore, MD
NPI 1619810926ActiveIndividual· Otolaryngology, Plastic Surgery within the Head & Neck· Rochester, MN
Otolaryngology, Plastic Surgery within the Head & Neck (MD) in Rochester, Minnesota, licensed in MN, with an NPI issued in April 2026. Enrolled in Medicare as order and referring only - otolaryngology.
Overview
| NPI | 1619810926 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MD |
| Sole proprietor | No |
| NPI issued | Apr 11, 2026 |
| Last updated in NPPES | Apr 27, 2026 |
| Certified by provider | Apr 27, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Otolaryngology, Plastic Surgery within the Head & Neck Primary | 207YX0007X | 36291 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Otolaryngology (MN) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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