Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Martin Ryan Moon, MD

Individual provider Surgery Physician · NPI 1174516934

Dr. Martin Ryan Moon, MD is a General Surgery in Florence, Kentucky. Graduated from Creighton University School of Medicine in 1994, 32 years ago. Practices with Summit Medical Group Inc, a 799-clinician group and accepts Medicare assignment. Licensed in Kentucky and Ohio.

Years since qualifying
32
Trained at
Creighton University School of Medicine
Licensed in
KY, OH
In the registry since
2005
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

4900 Houston Rd
Florence, KY 41042-4824
Phone: (859) 578-5880
Fax: (859) 578-5881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 39444 (KY)
Surgery Physician Taxonomy 208600000X · Licence 35-070819 (OH)

Record details

NPI number1174516934
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 26, 2005
Last updated in NPPESNovember 18, 2021
Certification dateNovember 18, 2021
Mailing addressPo Box 635283, Cincinnati, OH 45263-5283

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Also practisesTHORACIC SURGERY
Medical schoolCREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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