Active NPI
Michael J Moore, M.D.
- Therapeutic Radiology Physician
- Sierra Vista, AZ
National Provider Identifier
1073562476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Therapeutic Radiology Physician
- License
- 10112
- Practice address
- 5151 E. Hwy 90
Sierra Vista, AZ 85635 - Phone
- (520) 803-6644
- Fax
- (520) 544-2943
- NPI assigned
- May 10, 2006
- Last updated
- Mar 5, 2013
- 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 |
|---|---|---|---|---|
| Therapeutic Radiology Physician | 2085R0203X | 10112 | AZ | Primary |
Addresses
Primary practice location
5151 E. Hwy 90
Sierra Vista, AZ 85635
Mailing address
5151 E. Hwy 90
Sierra Vista, AZ 85635
Phone (520) 519-7720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 237851 | Medicaid | AZ |
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 |
|---|---|---|---|
| Cochise Oncology LLC | Past | Accepting new patients | |
| Cochise Medical Oncology, LLC | Past | Accepting new patients | |
| Arizona Oncology Associates PC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Sierra Vista, AZ
- NPI 1245663319
-
- Radiation Oncology Physician
- Sierra Vista, AZ
- NPI 1013954858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1073562476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 E. HWY 90",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "85635",
"telephone_number": "520-519-7720",
"fax_number": "520-519-5181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 E. HWY 90",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "85635",
"telephone_number": "520-803-6644",
"fax_number": "520-544-2943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-10",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0203X",
"taxonomy_group": "",
"desc": "Radiology, Therapeutic Radiology",
"state": "AZ",
"license": "10112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "237851",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sierra Vista, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.