Douglas R Moore, D.O.

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

5101013212 Issued in MI

Practice address

25195 Kelly Rd Ste a
Roseville, MI 48066-4909

Phone

(586) 775-4594

Fax

(586) 775-4506

NPI assigned

Jun 9, 2005

Last updated

Oct 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Westshore Cardiology ServicesGroup PAC ID 5991932360, 36 clinicians

Advantage Health/Saint Mary's Medical GroupGroup PAC ID 4082807961, 499 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Muskegon Hospital Hospital, Muskegon, MI, CCN 230066
• Mercy Health Saint Mary's Hospital, Grand Rapids, MI, CCN 230059
• Mercy Health Lakeshore Campus Hospital, Shelby, MI, CCN 231320
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
• Corewell Health Ludington Hospital Hospital, Ludington, MI, CCN 230110

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as apm

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

88.97

Promoting interoperability

98.2

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

88.97

Promoting interoperability

98.2

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dmoore3760975@direct.trinity-health.org
• FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Advantage Health/Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment Care Compare group NPD
• Mercy Health Westshore Cardiology Services

  dba Trinity Health Medical Group

  • Cardiovascular Disease Physician
  • Muskegon, MI
  • NPI 1336573393
  Medicare reassignment Care Compare group NPD
• Eastlake Cardiovascular PC

  • Cardiovascular Disease Physician
  • Saint Clair Shores, MI
  • NPI 1982657474
  Medicare reassignment NPD
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472

  Cardiovascular Disease

  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  dba St John North Shores Hospital

  • Podiatrist
  • Harrison Township, MI
  • NPI 1043478910
  Medicare reassignment NPD
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group Orthopedics Grand Rapids

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary's Medical Group

  dba Trinity Health Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Henry Ford Cornerstone Medical Group

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1851765374
  NPD
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health St. John Hospital

  dba Henry Ford St John Hospital

  • Multi-Specialty Clinic/Center
  • Detroit, MI
  • NPI 1457663197
  NPD
• Henry Ford Health St. John Hospital

  dba Henry Ford St John Hospital

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1912965088
  NPD
• Henry Ford Health St. John Hospital

  dba St John Hospital and Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

• Memorial Medical Center of West Michigan

  dba Corewell Health Ludington Hospital

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  Care Compare affiliation
• Mercy Health Partners

  dba MHP - Lakeshore Campus

  • Critical Access Hospital
  • Shelby, MI
  • NPI 1285662981
  Care Compare affiliation
• Mercy Health Partners

  dba Mercy Health Muskegon

  • General Acute Care Hospital
  • Muskegon, MI
  • NPI 1831132133
  Care Compare affiliation
• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Saint Mary's Health Services

  dba Mercy Health Saint Mary's

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1194729053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25195 KELLY RD STE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664909",
            "telephone_number": "586-775-4594",
            "fax_number": "586-775-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25195 KELLY RD STE A",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664909",
            "telephone_number": "586-775-4594",
            "fax_number": "586-775-4506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1223 Mercy Dr",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494441829",
            "country_code": "US",
            "telephone_number": "231-672-3500",
            "fax_number": "231-672-6199",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Lafayette Ave SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034693",
            "country_code": "US",
            "telephone_number": "616-685-3450",
            "fax_number": "616-685-3454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DOUGLAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "VA",
            "license": "0102202087",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "VA",
            "license": "0102202087",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MI",
            "license": "5101013212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Montoni, D.P.M.
• Gregory G Montpetit, M.D.
• Michael Joseph Mooney, MA,LLP,CAC,CCS,CCJP
• Andrew William James Moore, DO
• Donald R Moore, M.D.
• Gennea Nickole Moore, LLP
• Nona Moore
• Courtney Morgott, FNP
• Jessica Jean Morrison
• Shyam Sunder Moudgil, MD

• Clinical Cardiac Electrophysiology Physician in Roseville, MI
• Providers in Roseville, MI by specialty
• Clinical Cardiac Electrophysiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.