Nicholas Jay Moore, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

4301108292 Issued in MI

Practice address

26850 Providence Pkwy Ste 260
Novi, MI 48374-1256

Phone

(248) 465-5140

Fax

(248) 465-5141

NPI assigned

Jun 14, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Sports MedicineAlso: Family Practice

Education

Medical College of Wisconsin, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277
• Henry Ford Health St John Hospital Hospital, Detroit, MI, CCN 230165
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as apm

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmoore1057120@direct.hfhs.org
• Direct secure messaging: nmoore3@direct.dmc.org

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment Care Compare group NPD
• VHS Physicians of Michigan

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

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

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• VHS Huron Valley-Sinai Hospital Inc

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation
• VHS Rehabilitation Institute of Michigan Inc

  • Rehabilitation Hospital
  • Detroit, MI
  • NPI 1871805150

  Inpatient rehabilitation facility

  Care Compare affiliation
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  Care Compare affiliation

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1265727556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 260",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741256",
            "telephone_number": "248-465-5140",
            "fax_number": "248-465-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26850 PROVIDENCE PKWY STE 260",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741256",
            "telephone_number": "248-465-5140",
            "fax_number": "248-465-5141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 S Latson Rd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488437643",
            "country_code": "US",
            "telephone_number": "248-465-5140",
            "fax_number": "248-465-5141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28300 Orchard Lake Rd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483343704",
            "country_code": "US",
            "telephone_number": "248-539-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICHOLAS",
        "middle_name": "JAY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301108292",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "4301108292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph E Moore
• Karen Louise Moore, BS, MA
• Kenneth Moore
• Marilyn Moore
• Melissa Moore, OT
• Rachel Mary Moore
• Tabitha Moore
• Rebecca Marie Moorhouse, DO
• France Moosa, PHARMD
• Olivia Mora

• Sports Medicine (Family Medicine) Physician in Novi, MI
• Providers in Novi, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.

Verify at the official NPI Registry.