Individual provider Active NPI

Megan Kathleen Moore, CRNP

  • Adult Health Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1184993495
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
SP011747 Issued in PA
Practice address
3400 Spruce St
2 Ravdin
Philadelphia, PA 19104-4238
Phone
(215) 662-3606
Fax
(215) 349-5579
NPI assigned
Dec 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X SP011747 PA Primary

Addresses

Primary practice location

3400 Spruce St
2 Ravdin
Philadelphia, PA 19104-4238

Mailing address

3400 Spruce St
2 Ravdin
Philadelphia, PA 19104-4238
Phone (215) 662-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20120416000031 PA Practitioner - Nurse Practitioner 7719145465 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1800 Lombard St
Philadelphia, PA 19146-1414
Phone (215) 662-7810

Hospital & facility affiliations

  • Penn Presbyterian Medical Center Hospital, Philadelphia, PA, CCN 390223
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111
  • Riverview Regional Medical Center Hospital, Gadsden, AL, CCN 010046
  • Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP011747PAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Nov 1, 2019 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Nov 1, 2019 Accepting new patients
Care Alternatives of Pennsylvania, LLC CurrentSince Jan 4, 2026 Accepting new patients

Locations

65 Jackson Dr
Ste 103
Cranford, NJ 07016
Phone (908) 931-9068

1120 Welsh Rd
Ste 220
North Wales, PA 19454
Phone (215) 542-2100

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

3400 Spruce St
Fl 2
Philadelphia, PA 19104
Phone (215) 662-2428

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104

Organizations & group practices 4

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 6

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": "1323993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1184993495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-3606",
            "fax_number": "215-349-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "address_2": "2 RAVDIN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-3606",
            "fax_number": "215-349-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MEGAN",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-16",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "PA",
            "license": "SP011747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.