Individual provider Active NPI

Deborah Irene Moore, ARNP

  • Nurse Practitioner
  • Manchester, NH
National Provider Identifier
1326029273
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
044636-23-05 Issued in NH
Practice address
138 Webster St
Manchester, NH 03104-2512
Phone
(603) 663-7030
Fax
(603) 663-7039
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 044636-23-05 NH Primary

Addresses

Primary practice location

138 Webster St
Manchester, NH 03104-2512

Mailing address

138 Webster St
Manchester, NH 03104-2512
Phone (603) 663-7030

Other identifiers 7

IdentifierTypeStateIssuer
23YP04736NH01OtherNHANTHEM ACES PIN
P00118051OtherNHRR MEDICARE PIN
044363OtherNHTUFTS PIN
30102YOtherNHANTHEM REFERRING RAN
30342539MedicaidNH
5796011OtherNHCIGNA PIN
S67113OtherNHHPHC PIN

Other names 1

  • Deborah Moore Kuzma Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20050718000138 NH Practitioner - Nurse Practitioner 7416983879 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elliot Physicians Network CurrentSince May 12, 2003 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

138 Webster St
Manchester, NH 03104
Phone (603) 645-5977

275 Mammoth Rd
Manchester, NH 03109
Phone (603) 663-8300

275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326029273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 WEBSTER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042512",
            "telephone_number": "603-663-7030",
            "fax_number": "603-663-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 WEBSTER ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031042512",
            "telephone_number": "603-663-7030",
            "fax_number": "603-663-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEBORAH",
        "middle_name": "IRENE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "044636-23-05",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ACES PIN",
            "identifier": "23YP04736NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "P00118051",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS PIN",
            "identifier": "044363",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM REFERRING RAN",
            "identifier": "30102Y",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30342539",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PIN",
            "identifier": "5796011",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC PIN",
            "identifier": "S67113",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "KUZMA",
            "middle_name": "MOORE",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

Verify at the official NPI Registry.