Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kathryn Rose Moore, MD

Individual provider Internal Medicine Physician · NPI 1689850794

Dr. Kathryn Rose Moore, MD is a Hematology/Oncology in St Louis Park, Minnesota. Qualified in 2005, 21 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois and Oregon.

Years since qualifying
21
Licensed in
IL, OR
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3931 Louisiana Ave S
St Louis Park, MN 55426-5000
Phone: (952) 993-2750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hematology & Oncology Physician (primary) Taxonomy 207RH0003X · Licence MD154557 (OR)
Internal Medicine Physician Taxonomy 207R00000X · Licence 125050108 (IL)

Record details

NPI number1689850794
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedJanuary 18, 2008
Last updated in NPPESJanuary 8, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHEMATOLOGY/ONCOLOGY
Also practisesINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations10 on file with Medicare

Other providers in St Louis Park