Individual provider Active NPI

Clea J Moore, MD

  • Family Medicine Physician
  • Winter Park, FL
National Provider Identifier
1104352954
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME161392 Issued in FL
Practice address
133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone
(407) 646-7070
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 283905 MA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME161392 FL Primary

Addresses

Primary practice location

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111

Mailing address

133 Benmore Dr Ste 200
Winter Park, FL 32792-4111
Phone (407) 646-7070

Other practice location 1

600 Clark Rd Ste 3
Tewksbury, MA 01876-1698
Phone (978) 851-4141

Other practice location 2

850 5th Ave E
Tuscaloosa, AL 35401-7419
Phone (205) 348-1770

Other practice location 3

7975 Lake Underhill Rd Ste 200
Orlando, FL 32822-8204
Phone (407) 303-6830

Other practice location 4

7975 Lake Underhill Rd Ste 310
Orlando, FL 32822-8205
Phone (407) 303-6820

Other practice location 5

2501 N Orange Ave Ste 411
Orlando, FL 32804-4644
Phone (407) 303-7298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241107000738 NC Practitioner - Family Practice 8921372186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Connecticut School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

12925 Hwy 601
Suite 300
Midland, NC 28107-9536
Phone (704) 888-3702

270 Copperfield Blvd NE
Suite 102
Concord, NC 28025-2443
Phone (704) 786-6521

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Lowell General Hospital Hospital, Lowell, MA, CCN 220063

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME161392FLMDFamily Medicine Physician
4561ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 14, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 14, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Oct 14, 2024 Accepting new patients
LGH Professional Services LLC Past Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients
Carolinas Physicians Network, Inc Family Medicine Past Accepting new patients

Locations

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

270 Copperfield Blvd NE
Ste 10
Concord, NC 28025
Phone (704) 721-7430

12925 Highway 601
Ste 300
Midland, NC 28107
Phone (704) 258-2444

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

Interoperability endpoints

  • Direct secure messaging: cmoore2943856@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1104352954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BENMORE DR STE 200",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327924111",
            "telephone_number": "407-646-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Clark Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Tewksbury",
            "state": "MA",
            "postal_code": "018761698",
            "country_code": "US",
            "telephone_number": "978-851-4141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "850 5th Ave E",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354017419",
            "country_code": "US",
            "telephone_number": "205-348-1770",
            "fax_number": "205-348-6561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7975 Lake Underhill Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328228204",
            "country_code": "US",
            "telephone_number": "407-303-6830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7975 Lake Underhill Rd Ste 310",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328228205",
            "country_code": "US",
            "telephone_number": "407-303-6820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2501 N Orange Ave Ste 411",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044644",
            "country_code": "US",
            "telephone_number": "407-303-7298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CLEA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "283905",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME161392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.