Dudley T Moorhead II, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

MD00016496 Issued in WA

Practice address

1135 116TH Ave NE Ste 220
Bellevue, WA 98004-4623

Phone

(425) 450-7007

Fax

(425) 450-0026

NPI assigned

Jul 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Eastside Vascular LLP

  • Vascular Surgery Physician
  • Bellevue, WA
  • NPI 1356471833
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1306864673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 220",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-450-7007",
            "fax_number": "425-450-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 220",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044623",
            "telephone_number": "425-450-7007",
            "fax_number": "425-450-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORHEAD",
        "first_name": "DUDLEY",
        "middle_name": "T",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD00016496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371004",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mehri D Moore, M.D.
• Michael R. Moore, DPT
• Peter Emery Moore, D.D.S.
• Robin R Moore, PAC
• Tara Moore
• Alec Jay Moorman, MD
• Candy Morales, LMT
• Kayla Morales
• Kristina M Morales, CDP
• Matthew Morales, MS, MHP

• Vascular Surgery Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Vascular Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.