Moore Dermatology SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036075509 Issued in IL

Legal business name

MOORE DERMATOLOGY SC

Practice address

501 W North Ave Ste 103
Melrose Park, IL 60160-1603

Phone

(708) 450-5086

Fax

(708) 345-4075

NPI assigned

Nov 15, 2007

Last updated

Feb 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie A Moore, MDNPI 1053373589

Title

Physician

Phone

(708) 450-5086

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• Direct secure messaging: juliemoore@moore.emadirect.md

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie A Moore, M.D.

  • Dermatology Physician
  • Melrose Park, IL
  • NPI 1053373589
  Medicare reassignment Care Compare group NPD Authorized official
• Michaela Rose Reinhart, PA-C

  • Physician Assistant
  • Melrose Park, IL
  • NPI 1710510391
  Medicare reassignment Care Compare group
• Tracy Marie Allen Campbell, M.D.

  • Dermatology Physician
  • Melrose Park, IL
  • NPI 1598921249
  NPD

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1659552875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W NORTH AVE STE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601603",
            "telephone_number": "708-450-5086",
            "fax_number": "708-345-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W NORTH AVE STE 103",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601603",
            "telephone_number": "708-450-5086",
            "fax_number": "708-345-4075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-450-5086",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036075509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JulieMoore@moore.emadirect.md",
            "affiliation": "N",
            "address_1": "501 W North Ave Ste 103",
            "city": "Melrose Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601601603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elisabeth Janette Miwa, MSN, APRN, AGNP-C
• Rizwan K Moinuddin, DO
• Robert Molnar, DO
• Yamilex Monarrez
• Francisco Javier Monteon Jr.
• Jameeka Dionndra Moore, PSY.D.
• Julie A Moore, M.D.
• Carmen Nieves Morales, MA
• Marc Anthony Moran
• Ann Moret, R.N. MSN C-CNS

• Dermatology Physician in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.