Individual provider Active NPI

Katharine Jeanne Moore, FNP-BC

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1598337180
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57350 Issued in NM
Practice address
8100 Constitution PL NE Ste 400
Albuquerque, NM 87110-7644
Phone
(505) 559-6024
NPI assigned
Jul 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 57350 NM Primary

Addresses

Primary practice location

8100 Constitution PL NE Ste 400
Albuquerque, NM 87110-7644

Mailing address

12421 Towner Ave NE
Albuquerque, NM 87112-3659
Phone (603) 620-0008

Other names 1

  • Katharine Jeanne Bonnette Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830000236 NM Practitioner - Nurse Practitioner 6507261534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1202 Hwy 60
Socorro, NM 87801-3914

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
57350NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 12, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince Oct 12, 2021 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

3901 Atrisco Dr NW
Albuquerque, NM 87120
Phone (505) 462-7575

8800 Montgomery Blvd NE
Albuquerque, NM 87111
Phone (505) 462-6400

8100 Constitution Pl NE
Ste 400
Albuquerque, NM 87110
Phone (505) 559-1122

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

2400 Unser Blvd SE
Rio Rancho, NM 87124
Phone (505) 253-0000

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

121 El Paso Rd
Ruidoso, NM 88345
Phone (505) 257-4061

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

1202 Highway 60
Bldg D
Socorro, NM 87801
Phone (575) 838-4690

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

Interoperability endpoints

  • Direct secure messaging: kmoore168936@direct.phs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1598337180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12421 TOWNER AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123659",
            "telephone_number": "603-620-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 CONSTITUTION PL NE STE 400",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107644",
            "telephone_number": "505-559-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHARINE",
        "middle_name": "JEANNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "57350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "BONNETTE",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.