Active NPI
Kellie Moore
- Pediatrics Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- RS2015-0351
- Practice address
- Msc10 5590 1 University of New Mexico
Albuquerque, NM 87131-0001 - Phone
- (505) 272-3120
- NPI assigned
- Mar 31, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NM | ||
| Pediatrics Physician | 208000000X | RS2015-0351 | NM | Primary |
Addresses
Primary practice location
Msc10 5590 1 University of New Mexico
Albuquerque, NM 87131-0001
Mailing address
933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Anesthesia Medical Group | Current | Accepting new patients | |
| UCSF Medical Group Business Services | Current | Accepting new patients | |
| University of California San Francisco | Pediatrics | Current | Accepting new patients |
| UCSF Medical Group Business Services | Current | Accepting new patients | |
| University of California San Francisco | Current | Accepting new patients | |
| University of California San Francisco | Current | Accepting new patients | |
| UCSF Medical Center | Past | Accepting new patients | |
| University of California San Francisco Medical Center | Past | Accepting new patients |
Locations
3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020
747 52nd St
Oakland, CA 94609
Phone (510) 428-3070
2001 The Embarcadero
Ofc Of
San Francisco, CA 94143
Phone (628) 224-5503
400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000
521 Parnassus Ave
Fl 4
San Francisco, CA 94143
Phone (415) 476-9035
505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058
2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444
521 Parnassus Ave
Rm 4615
San Francisco, CA 94143
Interoperability endpoints
- kmoore254493@direct-ucsfmedicalcenter.org
Organizations & group practices 8
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.
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1477624104
-
- Anesthesiology Physician
- San Francisco, CA
- NPI 1528137296
-
- Pediatrics Physician
- San Francisco, CA
- NPI 1861578973
-
- Health Service Clinic/Center
- San Francisco, CA
- NPI 1194115246
-
- Surgery Physician
- San Francisco, CA
- NPI 1346329380
-
- Community/Retail Pharmacy
- San Francisco, CA
- NPI 1659141711
-
- Anesthesiology Physician
- San Francisco, CA
- NPI 1205016011
-
- General Acute Care Hospital
- San Francisco, CA
- NPI 1144325440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434758400000",
"number": "1437544079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "933 BRADBURY DR SE",
"address_2": "SUITE 2222",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064374",
"telephone_number": "505-272-3120",
"fax_number": "505-272-8060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MSC10 5590 1 UNIVERSITY OF NEW MEXICO",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871310001",
"telephone_number": "505-272-3120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KELLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2015-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NM",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "RS2015-0351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.