Susanna Dorothy Moore

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

303653-01 Issued in NY

Practice address

111 E 210TH St
Bronx, NY 10467-2401

Phone

(718) 920-4678

NPI assigned

Apr 17, 2017

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Icahn School of Medicine at Mount SinaiGroup PAC ID 8224282926, 317 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elmhurst Hospital Center Hospital, Elmhurst, NY, CCN 330128
• New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: wwe9004@direct.nyp.org
• Direct secure messaging: smoore847417@nychhc.direct-ci.com
• Direct secure messaging: sumoore@montefioredirect.com

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.

• Icahn School of Medicine at Mount Sinai

  • Orthopaedic Surgery Physician
  • Elmhurst, NY
  • NPI 1609120674
  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  • Internal Medicine Physician
  • Elmhurst, NY
  • NPI 1184977324
  NPD
• Icahn School of Medicine at Mount Sinai

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1619221686
  NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD
• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Elmhurst, NY
  • NPI 1063426377
  NPD (past)

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

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Elmhurst, NY
  • NPI 1063426377
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1144504044
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • Ambulance
  • New York, NY
  • NPI 1174628473

  Hospital

  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1194832477
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • Bronxville, NY
  • NPI 1780196345
  Care Compare affiliation
• The New York and Presbyterian Hospital

  • General Acute Care Hospital
  • New York, NY
  • NPI 1952332801
  Care Compare affiliation

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1578097556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E 210TH ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672401",
            "telephone_number": "718-920-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSANNA",
        "middle_name": "DOROTHY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "303653-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Moore, M.D.
• Queenasia Simone Moore, LMT
• Robert Michael Moore, MD
• Sharona Changes Moore, MSW
• Stephanie Moore
• Tashawna Moore
• Yvonne Moore, MSW
• Danielle Moorer, MD
• Davaughn Moorer
• Rhonda N Moorer, LMSW

• Family Medicine Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Family Medicine Physician in New York

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