Active NPI
Kevin Phillip Moore
- Physician Assistant
- Binghamton, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 028505
- Practice address
- 169 Riverside Dr
Binghamton, NY 13905-4246 - Phone
- (607) 798-5231
- NPI assigned
- Mar 13, 2022
- Last updated
- Jul 20, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 028505 | NY | Primary |
Addresses
Primary practice location
169 Riverside Dr
Binghamton, NY 13905-4246
Mailing address
701 Dickson St
Endicott, NY 13760-4533
Phone (585) 943-8333
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
446 Fairview Ave
Suite 200
Hudson, NY 12534-1048
Phone (518) 267-3496
7375 Oswego Rd
Suite 1
Liverpool, NY 13090-3717
Phone (315) 291-0064
740 S Main St
Ithaca, NY 14850-5377
Phone (607) 319-4563
830 County Rd
Suite 64
Elmira, NY 14903-9719
Phone (607) 846-2030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellnow Urgent Care, PC | Current | Accepting new patients | |
| Ny Primary Care Practice, PC | Past | Accepting new patients |
Locations
5495 Sheridan Dr
Buffalo, NY 14221
Phone (716) 932-1198
446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496
7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064
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.
-
dba WellNow Urgent Care
- Urgent Care Clinic/Center
- Liverpool, NY
- NPI 1669825162
-
- Emergency Medical Services (Emergency Medicine) Physician
- Binghamton, NY
- NPI 1659464758
-
- Urgent Care Clinic/Center
- Hudson, NY
- NPI 1851890289
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1265180871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 DICKSON ST",
"city": "ENDICOTT",
"state": "NY",
"postal_code": "137604533",
"telephone_number": "585-943-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 RIVERSIDE DR",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139054246",
"telephone_number": "607-798-5231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KEVIN",
"middle_name": "PHILLIP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-03-13",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "028505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; 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.