Andrea Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.016158 Issued in IL

Practice address

12446 S Loomis St
Calumet Park, IL 60827-5832

Phone

(773) 641-7095

NPI assigned

Sep 7, 2016

Last updated

Sep 7, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Midwest Post Acute Care PLLCGroup PAC ID 0143547117, 125 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Midwest Post Acute Care PLLC

  • Nurse Practitioner
  • Chicago, IL
  • NPI 1083012074

  Clinical

  Medicare reassignment Care Compare group NPD
• Vitae Health Medical Illinois, PLLC

  • Internal Medicine Physician
  • Skokie, IL
  • NPI 1174013452

  Clinical

  Medicare reassignment Care Compare group NPD
• GLM Therapeutic Services, LLC

  dba GLM Counseling Services

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1184425381
  NPD Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1578010435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53529",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606530529",
            "telephone_number": "773-641-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12446 S LOOMIS ST",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "608275832",
            "telephone_number": "773-641-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lolita a. Wilburn D.C.P.C. (Back To Heatlh Chiropractic-Medical Center)
• Victoria Elizabeth Lopez
• Sharon McBride-Lindsey
• MGM Therapy & Behavioral Treatment Corporation
• Midwest Express Care 2, Inc
• Shybella Morgan
• Brianna Neal, LSW
• Kristie Sue Paprocki, SLP
• Katarzyna Para, FNP-C
• Prosper Mental Health Inc

• Clinical Social Worker in Calumet Park, IL
• Providers in Calumet Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.