Individual provider Active NPI

Sarah Moore, PA

  • Physician Assistant
  • Malone, NY
National Provider Identifier
1255883013
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
020259-1 Issued in NY
Practice address
5 Clay St
Malone, NY 12953-1905
Phone
(518) 483-0705
NPI assigned
Oct 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 020259-1 NY Primary

Addresses

Primary practice location

5 Clay St
Malone, NY 12953-1905

Mailing address

5 Clay St
Malone, NY 12953-1905
Phone (518) 483-0705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161201001193 NY Practitioner - Physician Assistant 1052691417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243

133 Park St
Malone, NY 12953-1244

134 Park St
Malone, NY 12953-1251
Phone (518) 481-2800

16 3Rd St a
Malone, NY 12953-1305
Phone (518) 481-2870

16 3Rd St B
Malone, NY 12953-1305
Phone (518) 481-2870

16 4TH St C
Malone, NY 12953-1340
Phone (518) 481-2896

183 Park St
Malone, NY 12953-1238

187 Park St
Suite 2
Malone, NY 12953-1233
Phone (518) 481-2790

20 4TH St
Suite 2
Malone, NY 12953-1339
Phone (518) 481-2677

23 4TH St
Malone, NY 12953-1331
Phone (518) 481-2880

23 Forth St
Suite 1
Malone, NY 12953-1238
Phone (518) 481-8080

24 4TH St
Suite 4
Malone, NY 12953-1350
Phone (518) 481-2632

45 6TH St
Malone, NY 12953-1246
Phone (518) 481-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020259NYMDOccupational Therapist
020259-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Physician Assistant CurrentSince Oct 1, 2019 Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

5 Clay St
Malone, NY 12953
Phone (518) 483-0705

15 4th St
Malone, NY 12953
Phone (518) 481-8160

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: smoore465460@direct.uvmhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1255883013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CLAY ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531905",
            "telephone_number": "518-483-0705",
            "fax_number": "518-483-1375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CLAY ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531905",
            "telephone_number": "518-483-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SARAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "020259-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.