Individual provider Active NPI

Andrew D Moore, MD

  • Psychiatry Physician
  • Fitchburg, WI
National Provider Identifier
1235146978
Registry record updated Nov 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
30681-020 Issued in WI
Practice address
2985 Rothmore LN
Fitchburg, WI 53711-5876
Phone
(608) 225-8584
NPI assigned
Aug 2, 2006
Last updated
Nov 20, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 30681-020 WI Primary

Addresses

Primary practice location

2985 Rothmore LN
Fitchburg, WI 53711-5876

Mailing address

2985 Rothmore LN
Fitchburg, WI 53711-5876
Phone (608) 225-8584

Other practice location 1

1050 Spaight St
Madison, WI 53703-3506
Phone (608) 255-5626

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20090603000562 WI Practitioner - Psychiatry 8921099268 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30681-020WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rogers Memorial Hospital Incorporated CurrentSince Jan 1, 2018 Accepting new patients
Rogers Behavioral Health Practice - California PC Psychiatry PastSince Mar 30, 2025 Accepting new patients
Rogers Behavioral Health, Inc. PastSince Oct 6, 2019 Accepting new patients
Rogers Behavioral Health, Inc. Past Accepting new patients
Capitol Associates, SC Psychiatry Past Accepting new patients

Locations

1205 Corporate Center Dr
Oconomowoc, WI 53066
Phone (262) 567-4828

1230 Corporate Center Dr
Ste 400
Oconomowoc, WI 53066
Phone (262) 560-1527

34700 Valley Rd
Oconomowoc, WI 53066

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511136000000",
    "number": "1235146978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2985 ROTHMORE LN",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115876",
            "telephone_number": "608-225-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2985 ROTHMORE LN",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115876",
            "telephone_number": "608-225-8584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Spaight St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537033506",
            "country_code": "US",
            "telephone_number": "608-255-5626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2017-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "30681-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, WI

Sources for this page

Verify at the official NPI Registry.