Rosalie Moore, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

28027184A Issued in IN

Practice address

2240 E 53Rd St # B-1
Indianapolis, IN 46220-3479

Phone

(317) 653-2730

Fax

(317) 321-1935

NPI assigned

Jun 9, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rosalie Baker Former name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rosalie.moore@oakstreethealth.gwaydirect.com

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.

• Circle City Foot and Medical Care

  • Geriatric Medicine (Internal Medicine) Physician
  • Indianapolis, IN
  • NPI 1215892294
  Medicare reassignment NPD Authorized official
• Osh-in Physicians Group, PC

  • Primary Care Clinic/Center
  • Indianapolis, IN
  • NPI 1073995338
  Medicare reassignment NPD
• Dignity & Hope Hospice

  • Community Based Hospice Care Agency
  • Indianapolis, IN
  • NPI 1164262275
  NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643
  NPD (past)

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1104355379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MONROE ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606032420",
            "telephone_number": "312-733-9730",
            "fax_number": "773-866-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 E 53RD ST # B-1",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203479",
            "telephone_number": "317-653-2730",
            "fax_number": "317-321-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROSALIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-09",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "28027184A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "28027184A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSALIE",
            "last_name": "BAKER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patryce Jeanale Moore
• Patty Lynn Moore, LCSW
• Polly Anne Moore, MD
• Priscilla Hope Moore
• Reilin James Moore, M.D.
• Savannah A Moore, OT
• Seth Allen Moore, MD
• Spencer Moore
• Suzann Moore, CSFA
• Tara Moore

• Gerontology Nurse Practitioner in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.