Andrew William James Moore, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101029451 Issued in MI

Practice address

18325 E 10 Mile Rd
Roseville, MI 48066-4990

Phone

(586) 447-4000

NPI assigned

May 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Family Practice

Education

Michigan State University College of Osteopathic Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1275224065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18325 E 10 MILE RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664990",
            "telephone_number": "586-447-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM JAMES",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-15",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101029451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amoore1247507@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "18325 E 10 Mile Rd",
            "city": "Roseville",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480664990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mohammad Sunbulli MD PLLC
• Sabah M Mohammed, MD
• John Montoni, D.P.M.
• Gregory G Montpetit, M.D.
• Michael Joseph Mooney, MA,LLP,CAC,CCS,CCJP
• Donald R Moore, M.D.
• Douglas R Moore, D.O.
• Gennea Nickole Moore, LLP
• Nona Moore
• Courtney Morgott, FNP

• Family Medicine Physician in Roseville, MI
• Providers in Roseville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.