Active NPI
Colleen Moore, MD
- Ophthalmology Physician
- Boston, MA
National Provider Identifier
1417268871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 244677
- Practice address
- 2100 Dorchester Avenue
Carney Hospital
Boston, MA 02124 - Phone
- (617) 506-2726
- NPI assigned
- Jun 30, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 244677 | MA | Primary |
Addresses
Primary practice location
2100 Dorchester Avenue
Carney Hospital
Boston, MA 02124
Mailing address
2100 Dorchester Avenue
Carney Hospital
Boston, MA 02124
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 244677 | MA | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277856000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1417268871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 DORCHESTER AVENUE",
"address_2": "CARNEY HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 DORCHESTER AVENUE",
"address_2": "CARNEY HOSPITAL",
"city": "BOSTON",
"state": "MA",
"postal_code": "02124",
"telephone_number": "617-506-2726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "COLLEEN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-30",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "244677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.