Active NPI
Thomas K Moore, M.D.
- Ophthalmology Physician
- East Lansing, MI
National Provider Identifier
1013992247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 4301047643
- Practice address
- 2001 Coolidge Rd
East Lansing, MI 48823-1378 - Phone
- (517) 337-1668
- Fax
- (517) 337-1779
- NPI assigned
- Dec 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 4301047643 | MI | Primary |
Addresses
Primary practice location
2001 Coolidge Rd
East Lansing, MI 48823-1378
Mailing address
2001 Coolidge Rd
East Lansing, MI 48823-1378
Phone (517) 337-1668
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TM047643 | Other | MI | STATE LICENSE NUMBER |
| 180011842 | Other | MI | RAILROAD MEDICARE |
| 1614148 | Medicaid | MI | |
| 200000002424 | Other | MI | PHPMM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lo Optical, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Eyewear Supplier
- Battle Creek, MI
- NPI 1548743537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1220400000000",
"number": "1013992247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 COOLIDGE RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488231378",
"telephone_number": "517-337-1668",
"fax_number": "517-337-1779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 COOLIDGE RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488231378",
"telephone_number": "517-337-1668",
"fax_number": "517-337-1779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "THOMAS",
"middle_name": "K",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2008-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MI",
"license": "4301047643",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "TM047643",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "180011842",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1614148",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHPMM",
"identifier": "200000002424",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.