Individual provider Active NPI

Scott Macleod Moore, M.D.

Pediatrics Physician
Chelsea, MI

National Provider Identifier

1497709513

Registry record updated Aug 7, 2025

On this page

Key facts
NPPES NPI Registry
Medicare participation
National Provider Directory
Organizations & group practices1
NPI Registry JSON
Other providers in Chelsea, MI
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Pediatrics PhysicianTaxonomy code 208000000X
License: 4301073339 Issued in MI
Practice address: 13699 Old US 12
Chelsea, MI 48118
Phone: (734) 475-4500
Fax: (734) 475-4507
NPI assigned: May 22, 2006
Sex: Male
Sole proprietor: No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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
Pediatrics Physician	208000000X	4301073339	MI	Primary

Addresses

Primary practice location

13699 Old US 12
Chelsea, MI 48118

Mailing address

13699 Old US 12
Chelsea, MI 48118
Phone (734) 475-4500

Other practice location 1

760 W Eisenhower Pkwy Ste 208
Ann Arbor, MI 48103-6196
Phone (734) 475-4500

Other identifiers 8

Identifier	Type	State	Issuer
3508144121	Other	MI	BCBS-INDIVIDUAL
4689652	Medicaid	MI
6U4708	Other		HAP
024175	Other	MI	MIDWEST HP-MEDICAID
5526527	Other	MI	AENTA
201711014	Other	MI	TRICARE
1220066	Other	MI	PHP
OH11422	Other		BCBS/BCN GROUP

Electronic endpoints 3

Type	Endpoint	Use
Direct Messaging Address	scott.moore.1@3566.direct.athenahealth.com	Direct
Direct Messaging Address	scott.moore.1@33161.direct.athenahealth.com	Direct
Direct Messaging Address	scott.moore.1@3566.direct.athenahealth.com	Direct

Medicare participation

Medicare enrollment files

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

National Provider Directory

Medicare enrollment (NPD): Not enrolled
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
4301073339	MI	MD	Pediatrics Physician

Practice roles

Organization	Specialty	Status	New patients
Pediatric Care of Chelsea, PC	Pediatrics	Past	Accepting new patients

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/3566/brand/1/csg/1/fhir/r4
Direct secure messaging: smoore503533@direct.hfhs.org
Direct secure messaging: scott.moore.1@33161.direct.athenahealth.com
Direct secure messaging: scott.moore.1@3566.direct.athenahealth.com

Organizations & group practices 1

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.

Pediatric Care of Chelsea, PC
- Pediatrics Physician
- Chelsea, MI
- NPI 1447321955
NPD (past) Authorized official

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1497709513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13699 OLD US 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "48118",
            "telephone_number": "734-475-4500",
            "fax_number": "734-475-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13699 OLD US 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "48118",
            "telephone_number": "734-475-4500",
            "fax_number": "734-475-4507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 W Eisenhower Pkwy Ste 208",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481036196",
            "country_code": "US",
            "telephone_number": "734-475-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SCOTT",
        "middle_name": "MACLEOD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301073339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-INDIVIDUAL",
            "identifier": "3508144121",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4689652",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "6U4708",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HP-MEDICAID",
            "identifier": "024175",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AENTA",
            "identifier": "5526527",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "201711014",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "1220066",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/BCN GROUP",
            "identifier": "OH11422",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scott.moore.1@3566.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Pediatric Care of Chelsea DBA Green Tree Pediatrics Athena EMR Direct message email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pediatric Care of Chelsea DBA Green Tree Pediatrics Athena EMR Direct message email address",
            "address_1": "760 W Eisenhower Pkwy Ste 208",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481036196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scott.moore.1@33161.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Pediatric Care of Chelsea Athena EMR Direct Message email address in new table space",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pediatric Care of Chelsea Athena EMR",
            "address_1": "13699 OLD US 12",
            "city": "CHELSEA",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "scott.moore.1@3566.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Pediatric Care of Chelsea DBA Green Tree Pediatrics Athena EMR Direct message email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pediatric Care of Chelsea DBA Green Tree Pediatrics Athena EMR Direct message email address",
            "address_1": "13699 OLD US 12",
            "city": "CHELSEA",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.