NPIMap

Individual provider Active NPI

Corinne Lenore Moore, PA-C

  • Physician Assistant
  • Edgewood, KY
National Provider Identifier
1225203128
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1096 Issued in KY
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-2160
Fax
(859) 301-3932
NPI assigned
Apr 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1096 KY
Specialist 174400000X 1096 KY
Medical Physician Assistant 363AM0700X PA1096 KY
Physician Assistant 363A00000X PA1096 KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 932163
Cleveland, OH 44193-0001
Phone (586) 412-4000

Other identifiers 2

IdentifierTypeStateIssuer
P00920661OtherRRMC
7100056830MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN, OH3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20081007000739 KY Practitioner - Physician Assistant 3577631217 Reassigns benefits to 1 organization
I20221101001998 IN Practitioner - Physician Assistant 3577631217 Reassigns benefits to 1 organization
I20241106003699 OH Practitioner - Physician Assistant 3577631217 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Radiology Associates of Northern Kentucky PLLCGroup PAC ID 3779480736, 56 clinicians
Gcga Physicians Inc.Group PAC ID 4284618224, 76 clinicians

Practice addresses (Care Compare)

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (859) 301-2160

10220 Alliance Rd
Blue Ash, OH 45242-4710
Phone (513) 841-7800

135 Courthouse Xing
Independence, KY 41051-2509
Phone (859) 301-0990

2000 Joseph E Sanker Blvd
Cincinnati, OH 45212-1979
Phone (513) 841-7400

2925 Vernon PL
Cincinnati, OH 45219-2425

3301 Mercy Health Blvd
Suite 525
Cincinnati, OH 45211-1118
Phone (513) 841-7700

3910 Eagleedge CT
Independence, KY 41051-2509
Phone (859) 331-4369

4360 Ferguson Dr
Suite 100
Cincinnati, OH 45245-1683
Phone (513) 841-7750

4746 Montgomery Rd
Suite 202
Norwood, OH 45212-2628
Phone (513) 751-6667

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5420

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 572-3140

925 Deis Dr
Fairfield, OH 45014-8130
Phone (513) 841-7900

Hospital & facility affiliations

  • Bethesda North Hospital, Cincinnati, OH, CCN 360179
  • Good Samaritan Hospital Hospital, Cincinnati, OH, CCN 360134
  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.83 of 100Reported as group
Promoting interoperability
98
Improvement activities
40
Cost
83.09

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1096KYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tri State Urologic Services PSC Inc CurrentSince Oct 22, 2024 Accepting new patients
Tri State Urologic Services PSC Inc CurrentSince Oct 22, 2024 Accepting new patients
St Elizabeth Medical Center, Inc Past Accepting new patients
Tri State Urologic Services PSC Inc Medical Past Accepting new patients

Locations

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

330 Roland Ave
Owenton, KY 40359
Phone (502) 484-3663

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

4746 Montgomery Rd
Ste 201
Cincinnati, OH 45212
Phone (513) 731-2273

4360 Ferguson Dr
Ste 100
Cincinnati, OH 45245
Phone (513) 841-7750

2000 Joseph E Sanker Blvd
Norwood, OH 45212
Phone (513) 841-7400

Organizations & group practices 7

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 10

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": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1225203128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932163",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930001",
            "telephone_number": "586-412-4000",
            "fax_number": "586-412-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2160",
            "fax_number": "859-301-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CORINNE",
        "middle_name": "LENORE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-23",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "1096",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "KY",
            "license": "1096",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA1096",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00920661",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100056830",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.