NPIMap

Individual provider Active NPI

Michael F Moore, M.D.

  • Vascular Surgery Physician
  • Clarks Summit, PA
National Provider Identifier
1235165168
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD022692E Issued in PA
Practice address
604 Division St
Clarks Summit, PA 18411-1928
Phone
(570) 319-6933
NPI assigned
Jun 23, 2006
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD022692E PA
Vascular Surgery Physician 2086S0129X MD022692E PA Primary

Addresses

Primary practice location

604 Division St
Clarks Summit, PA 18411-1928

Mailing address

604 Division St
Clarks Summit, PA 18411-1928
Phone (570) 319-6933

Other identifiers 1

IdentifierTypeStateIssuer
0007164390005MedicaidPA

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
I20101227000651 PA Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Chiropractic 5395757967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: Chiropractic, General Surgery
Education
Albany Medical College of Union University, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 S Main St
Old Forge, PA 18518-1606
Phone (570) 457-8364

746 Jefferson Ave
Scranton, PA 18510-1624
Phone (570) 340-5079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.17 of 100Reported as apm
Quality
78.34
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue222
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lane Chiropractic and Medical Center CurrentSince Dec 1, 2021 Accepting new patients
Scranton Quincy Clinic Company LLC CurrentSince Dec 1, 2023 Accepting new patients
Scranton Quincy Clinic Company LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

150 Brooklyn St
Carbondale, PA 18407
Phone (570) 282-2031

1000 Meade St
Dunmore, PA 18512
Phone (570) 504-2500

315 S Main St
Old Forge, PA 18518
Phone (570) 457-8364

746 Jefferson Ave
Scranton, PA 18510
Phone (570) 340-5079

802 Jefferson Ave
Scranton, PA 18510
Phone (570) 346-7331

166 W Tioga St
Tunkhannock, PA 18657
Phone (570) 836-2751

Organizations & group practices 3

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1235165168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 DIVISION ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111928",
            "telephone_number": "570-319-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 DIVISION ST",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111928",
            "telephone_number": "570-319-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD022692E",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "PA",
            "license": "MD022692E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007164390005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

Verify at the official NPI Registry.