Geoffrey E. Moore, M.D., P.C.

Primary specialty

Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X

License

227508-01 Issued in NY

Legal business name

GEOFFREY E. MOORE, M.D., P.C.

Doing business as

Healthy Living & Exercise Medicine Associates

Practice address

310 Taughannock Blvd
Suite 5B
Ithaca, NY 14850-3231

Phone

(607) 257-5990

Fax

(607) 257-5973

NPI assigned

Mar 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Geoffrey E Moore, M.D.NPI 1609976331

Title

President

Phone

(607) 257-5990

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Healthy Living & Exercise Medicine Associates Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Geoffrey E. Moore, M.D.

  • Sports Medicine (Internal Medicine) Physician
  • New Hartford, NY
  • NPI 1609976331
  NPD (past) Authorized official

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497887905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "address_2": "SUITE 5B",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503231",
            "telephone_number": "607-257-5990",
            "fax_number": "607-257-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 TAUGHANNOCK BLVD",
            "address_2": "SUITE 5B",
            "city": "ITHACA",
            "state": "NY",
            "postal_code": "148503231",
            "telephone_number": "607-257-5990",
            "fax_number": "607-257-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEOFFREY E. MOORE, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "607-257-5990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "NY",
            "license": "227508-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NOW",
            "identifier": "000927628004",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP  GROUP #J168",
            "identifier": "10077558",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "363245",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI HMO",
            "identifier": "000000076465",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKER'S COMP",
            "identifier": "227508-9W",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI PPO & CMP",
            "identifier": "2592101",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Living & Exercise Medicine Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul R Geisler, ED.D, ATC
• Steven A Gelber, M.D.
• Genoa Healthcare LLC
• Donnie Gentry Jr., FNP-C
• Maria K. Gentry, D.O.
• Arthur Richard George, RPAC
• Donna L George, LCSW
• Jennifer A George, NP
• Kevin Saji George
• Amara Gerarden, RN

• Sports Medicine (Internal Medicine) Physician in Ithaca, NY
• Providers in Ithaca, NY by specialty
• Sports Medicine (Internal Medicine) Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.