Individual provider Active NPI

Maeghan Moore

  • Family Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1154057933
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704323982 Issued in MI
Practice address
1431 Airport Rd
Waterford, MI 48327-1809
Phone
(248) 479-6150
Fax
(248) 710-2200
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704323982 MI Primary

Addresses

Primary practice location

1431 Airport Rd
Waterford, MI 48327-1809

Mailing address

1431 Airport Rd
Waterford, MI 48327-1809
Phone (248) 479-6150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20221205002232 MI Practitioner - Nurse Practitioner 5597134080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pain Clinic Management Group PLLCGroup PAC ID 9537308192, 12 clinicians

Practice addresses (Care Compare)

2820 Crooks Rd
Suite 100
Rochester Hills, MI 48309-3620
Phone (586) 977-7246

Hospital & facility affiliations

  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Clinic Management Group, PLLC CurrentSince Nov 1, 2022 Accepting new patients
United Pain Therapies PLLC PastSince Nov 1, 2022 Accepting new patients

Locations

46325 W Twelve Mile Rd
Ste 335
Novi, MI 48377
Phone (248) 697-2880

2820 Crooks Rd
Ste 100
Rochester Hills, MI 48309
Phone (248) 266-9137

2820 Crooks Rd
Ste 200
Rochester Hills, MI 48309
Phone (248) 852-7484

35634 Dequindre Rd
Sterling Hts, MI 48310
Phone (586) 977-7246

1431 Airport Rd
Waterford, MI 48327
Phone (248) 479-6150

Interoperability endpoints

  • Direct secure messaging: maeghan.murphy@4299.securemail.prognocis.com

Organizations & group practices 2

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 1

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": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1154057933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 AIRPORT RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271809",
            "telephone_number": "248-479-6150",
            "fax_number": "248-710-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 AIRPORT RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271809",
            "telephone_number": "248-479-6150",
            "fax_number": "248-710-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MAEGHAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704323982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.