Individual provider Active NPI

Sara D Moore, APRN

  • Family Nurse Practitioner
  • Glastonbury, CT
National Provider Identifier
1427587179
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7033 Issued in CT
Practice address
27 Sycamore St Ste 300
Glastonbury, CT 06033-7208
Phone
(860) 657-5800
NPI assigned
Jun 7, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 7033 CT Primary

Addresses

Primary practice location

27 Sycamore St Ste 300
Glastonbury, CT 06033-7208

Mailing address

9 Chapman Rd
Marlborough, CT 06447-1341

Other practice location 1

163 Broadway St
Colchester, CT 06415-1022
Phone (860) 622-8819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20170824001712 CT Practitioner - Nurse Practitioner 4880966977 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7033CTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group, Inc CurrentSince Oct 1, 2017 Accepting new patients
Absolute Outcomes, LLC Past Accepting new patients

Locations

111 Salem Tpke
Ste 8
Norwich, CT 06360
Phone (860) 886-0023

55 Meriden Ave
Ste 1D
Southington, CT 06489
Phone (860) 276-5144

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1427587179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHAPMAN RD",
            "city": "MARLBOROUGH",
            "state": "CT",
            "postal_code": "064471341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SYCAMORE ST STE 300",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060337208",
            "telephone_number": "860-657-5800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Colchester",
            "state": "CT",
            "postal_code": "064151022",
            "country_code": "US",
            "telephone_number": "860-622-8819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SARA",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "7033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.