NPIMap

Individual provider Active NPI

Mercy Rossana Bayot Moore, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
National Provider Identifier
1114927399
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
2013-02457 Issued in NC
Practice address
1918 Randolph Rd Ste 220
Suite 220
Charlotte, NC 28207-1109
Phone
(704) 316-1125
Fax
(704) 316-1143
NPI assigned
Jul 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 2013-02457 NC Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X J9965 TX

Addresses

Primary practice location

1918 Randolph Rd Ste 220
Suite 220
Charlotte, NC 28207-1109

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1125

Other identifiers 1

IdentifierTypeStateIssuer
119250204MedicaidTX

Other names 1

  • Mercy Rossana De Guzman Bayot Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmoore100513@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140415000175 NC Practitioner - EndocrinologyPractitioner - Internal Medicine 9133393994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

1918 Randolph Rd
Suite 220
Charlotte, NC 28207-1109
Phone (704) 316-1125

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Ballantyne Medical Center Hospital, Charlotte, NC, CCN 340195

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-02457NCMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Endocrinology, Diabetes & Metabolism CurrentSince Mar 1, 2014 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Mar 1, 2014 Accepting new patients
Novant Health Medical Group, LLC Endocrinology, Diabetes & Metabolism Current Accepting new patients
The Presbyterian Hospital Current Accepting new patients
The Presbyterian Hospital CurrentSince Apr 25, 2023 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 25, 2023 Accepting new patients
Monzer H Yazji MD & Associates PLLC Endocrinology, Diabetes & Metabolism Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Valley Gastroenterology Clinic, P.a. Past Accepting new patients
Valley Medical Group PLLC Endocrinology, Diabetes & Metabolism PastSince Jan 1, 1999 Accepting new patients

Locations

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

1918 Randolph Rd
Ste 220
Charlotte, NC 28207
Phone (704) 316-1125

19485 Old Jetton Rd
Ste 270
Cornelius, NC 28031
Phone (704) 384-7700

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: mmoore100513@direct.novanthealth.org

Organizations & group practices 11

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 8

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1114927399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-1125",
            "fax_number": "704-316-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD STE 220",
            "address_2": "SUITE 220",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071109",
            "telephone_number": "704-316-1125",
            "fax_number": "704-316-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MERCY ROSSANA",
        "middle_name": "BAYOT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NC",
            "license": "2013-02457",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "J9965",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119250204",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoore100513@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1918 Randolph Rd Ste 220",
            "address_2": "Suite 220",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MERCY ROSSANA",
            "last_name": "BAYOT",
            "middle_name": "DE GUZMAN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.