Susan E Moore, MD FAAP

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

199585 Issued in NY

Practice address

154 Warren St
Glens Falls, NY 12801

Phone

(518) 798-9985

Fax

(518) 761-7043

NPI assigned

Mar 9, 2006

Sex

Female

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

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.

• Glens Falls Pediatric Consultants, PC

  • Pediatrics Physician
  • Glens Falls, NY
  • NPI 1598720369
  NPD (past)

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1336117019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 WARREN ST",
            "address_2": "PO BOX 141",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-798-9985",
            "fax_number": "518-761-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 WARREN ST",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-798-9985",
            "fax_number": "518-761-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "E",
        "credential": "MD  FAAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "199585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01574381",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Moak, CASAC
• Todd Monahan
• Stephen Anthony Monn, MD
• Kathleen Marie Monroe, RD CDN
• Kaitlyn Montgomery, PA-C
• Mary Elizabeth Moran, MS OTR/L
• Danielle Moriarity, FNP-C, MSN, BSN, RN
• Carolyn Morrill-Cummins, LCSW-R
• Gwendolyn S Morris-Dickinson, PA-C
• Adrian Anthony Morris, MD

• Pediatrics Physician in Glens Falls, NY
• Providers in Glens Falls, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.