Individual provider Active NPI

Charles Moore, M.D.

  • Otolaryngology Physician
  • Atlanta, GA
National Provider Identifier
1588775712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
44789 Issued in GA
Practice address
1365A Clifton Rd NE
Department of Otolaryngology
Atlanta, GA 30322-1013
Phone
(404) 778-3381
Fax
(404) 778-4295
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 44789 GA Primary

Addresses

Primary practice location

1365A Clifton Rd NE
Department of Otolaryngology
Atlanta, GA 30322-1013

Mailing address

1365A Clifton Rd NE
Department of Otolaryngology
Atlanta, GA 30322-1013
Phone (404) 778-3381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20130509000351 GA Practitioner - Otolaryngology 7012176779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Harvard Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Medical Care Foundation IncGroup PAC ID 4981501814, 1,003 clinicians

Practice addresses (Care Compare)

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3031
Phone (404) 616-1000

Correll Pavilion
80 Gilmer St.SE
Atlanta, GA 30303-9998
Phone (404) 616-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.24 of 100Reported as group
Quality
73.72
Promoting interoperability
100
Improvement activities
40
Cost
75.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44789GAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Apr 1, 1998 Accepting new patients
The Emory Clinic Inc CurrentSince Apr 23, 1998 Accepting new patients
Emory Medical Care Foundation Otolaryngology CurrentSince Apr 1, 1998 Accepting new patients
Emory Health Care Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1365 Clifton Rd NE
#A
Atlanta, GA 30322
Phone (404) 778-3381

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: cmoore21808@direct.emory.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healing Community CenterAtlanta, GA, CCN 111113 Federally qualified health center Corporate Director Feb 17, 2012

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588775712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365A CLIFTON RD NE",
            "address_2": "DEPARTMENT OF OTOLARYNGOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-3381",
            "fax_number": "404-778-4295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365A CLIFTON RD NE",
            "address_2": "DEPARTMENT OF OTOLARYNGOLOGY",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221013",
            "telephone_number": "404-778-3381",
            "fax_number": "404-778-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "44789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.