NPIMap

Individual provider Active NPI

Marianne Kidd Moore, M.D.

  • Internal Medicine Physician
  • Danvers, MA
National Provider Identifier
1649290776
Registry record updated Jun 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
228281 Issued in MA
Practice address
192 North St
North Shore Physicians Group
Danvers, MA 01923-1242
Phone
(978) 646-2100
Fax
(978) 646-2120
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 228281 MA Primary

Addresses

Primary practice location

192 North St
North Shore Physicians Group
Danvers, MA 01923-1242

Mailing address

192 North St
North Shore Physicians Group
Danvers, MA 01923-1242
Phone (978) 646-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060824000301 MA Practitioner - Internal Medicine 7113920554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

194 R N St
Danvers, MA 01923-1242
Phone (978) 646-2100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
228281MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc Internal Medicine CurrentSince Apr 1, 2008 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

194 North St
#R
Danvers, MA 01923
Phone (978) 561-6363

192 North St
Danvers, MA 01923
Phone (978) 646-2100

400 Highland Ave
Salem, MA 01970
Phone (781) 599-0220

Interoperability endpoints

  • Direct secure messaging: moore.marianne.nsmc@direct.partners.masshiway.net

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1649290776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 NORTH ST",
            "address_2": "NORTH SHORE PHYSICIANS GROUP",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231242",
            "telephone_number": "978-646-2100",
            "fax_number": "978-646-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 NORTH ST",
            "address_2": "NORTH SHORE PHYSICIANS GROUP",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019231242",
            "telephone_number": "978-646-2100",
            "fax_number": "978-646-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARIANNE",
        "middle_name": "KIDD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "228281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.