Gwendolyn Moore, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

336836 Issued in NY

Practice address

750 E Adams St
Syracuse, NY 13210-2306

Phone

(315) 474-1561

NPI assigned

Oct 9, 2014

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Nurse Practitioner

Education

State University of Ny Upstate Medical University, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr inGroup PAC ID 3274445796, 277 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmoore150167@direct.upstate.edu
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Department of Medicine Medical Serv GRP at Suny HLTH Sci Ctr Syr in

  • Internal Medicine Physician
  • Syracuse, NY
  • NPI 1063468239
  Medicare reassignment Care Compare group NPD
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1770671182
  Medicare reassignment NPD
• Patient First Medical Practice PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Brooklyn, NY
  • NPI 1255067955
  Medicare reassignment NPD
• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment NPD
• Syracuse Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1497796353
  Medicare reassignment NPD
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  NY

  Medicare reassignment NPD
• Department of Medicine Medical Service Group

  • Hematology & Oncology Physician
  • Homer, NY
  • NPI 1205104262
  NPD
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1346369212
  NPD
• Rochester General Hospital

  • General Acute Care Hospital
  • Rochester, NY
  • NPI 1255360517
  NPD
• Syracuse Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Syracuse, NY
  • NPI 1184886988
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1487058145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UPSTATE UNIVERSITY HOSPITAL",
            "address_2": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-464-5540",
            "fax_number": "315-991-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-474-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GWENDOLYN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2023-11-13",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swagatam Mookherjee, M.D.
• David Kyung Ho Moon
• Karen Moore-Guillaume, MSED
• Barbara R Moore, NPP
• Casey Nilsen Moore, D.O.
• Jalia Moore
• Jason Robert Moore, OTR/L
• Joi Moore
• Kalie Jolyn Moore, LMT
• Michael David Moore, M.D.

• Family Nurse Practitioner in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.