Individual provider Active NPI

Gerald W Moore, REGISTERED NURSE

  • Home Health Agency
  • Buffalo, NY
National Provider Identifier
1376985275
Registry record updated Jul 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
572866 Issued in NY
Practice address
360 Delaware
Suite 310
Buffalo, NY 14202-1620
Phone
(716) 852-5900
Fax
(716) 852-5913
NPI assigned
Jul 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 572866 NY Primary

Addresses

Primary practice location

360 Delaware
Suite 310
Buffalo, NY 14202-1620

Mailing address

360 Delaware Avet
Suite 310
Buffalo, NY 14202-1620
Phone (716) 852-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
572866NYMDHome Health Agency

NPI Registry JSON

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374451200000",
    "number": "1376985275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DELAWARE AVET",
            "address_2": "SUITE 310",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021620",
            "telephone_number": "716-852-5900",
            "fax_number": "716-852-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DELAWARE",
            "address_2": "SUITE 310",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142021620",
            "telephone_number": "716-852-5900",
            "fax_number": "716-852-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GERALD",
        "middle_name": "W",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "572866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.