NPIMap

Individual provider Active NPI

Carolyn Baindu Moore, M.D.

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1194169870
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2020020179 Issued in MO
Practice address
720 Westview Dr SW
Department of Surgery
Atlanta, GA 30310-1458
Phone
(404) 616-1426
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD482549 PA
Surgery Physician 208600000X 2020020179 MO Primary

Addresses

Primary practice location

720 Westview Dr SW
Department of Surgery
Atlanta, GA 30310-1458

Mailing address

145 Hospital Ave Ste 300
Du Bois, PA 15801-1465
Phone (678) 557-8078

Other practice location 1

145 Hospital Ave Ste 301
Du Bois, PA 15801-1465
Phone (814) 375-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231121000424 PA Practitioner - Thoracic Surgery 6204138415 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Pittsburgh School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians

Practice addresses (Care Compare)

145 Hospital Ave
Suite 301
Du Bois, PA 15801-1465
Phone (814) 503-4749

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020020179MOMDSurgery Physician
MD482549PAMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Oct 30, 2023 Accepting new patients
Dubois Regional Medical Center Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Oct 30, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 1, 2023 Accepting new patients
Dubois Regional Medical Center Surgery Past Accepting new patients

Locations

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

145 Hospital Ave
Ste 300
Dubois, PA 15801
Phone (814) 371-4524

145 Hospital Ave
Ste 301
Dubois, PA 15801
Phone (814) 375-4000

100 Hospital Ave
Ofc
Dubois, PA 15801

600 N 2nd St
Ste 401
Harrisburg, PA 17101
Phone (844) 341-2339

1163 Country Club Rd
Monongahela, PA 15063
Phone (724) 258-1000

1163 Country Club Rd
Fl 4
Monongahela, PA 15063
Phone (724) 374-4217

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • Direct secure messaging: cbmoore@1285.direct.myezyaccess.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1194169870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HOSPITAL AVE STE 300",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158011465",
            "telephone_number": "678-557-8078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DR SW",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101458",
            "telephone_number": "404-616-1426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Hospital Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Du Bois",
            "state": "PA",
            "postal_code": "158011465",
            "country_code": "US",
            "telephone_number": "814-375-2040",
            "fax_number": "814-375-2045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAROLYN",
        "middle_name": "BAINDU",
        "name_prefix": "Miss",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "PA",
            "license": "MD482549",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2020020179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.