Individual provider Active NPI

Elizabeth Catherine Moore, DO

  • Emergency Medicine Physician
  • Glendale, CA
National Provider Identifier
1659668093
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A15313 Issued in CA
Practice address
1812 Verdugo Blvd
Glendale, CA 91208-1407
Phone
(818) 790-7100
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OT013975 PA
Emergency Medicine Physician 207P00000X 20A15313 CA Primary

Addresses

Primary practice location

1812 Verdugo Blvd
Glendale, CA 91208-1407

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (818) 790-7100

Other practice location 1

2545 Schoenersville Road
5th Floor South
Bethlehem, PA 18017
Phone (484) 884-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170609001137 CA Practitioner - Medical ToxicologyPractitioner - Emergency Medicine 9739325416 Reassigns benefits to 1 organization
I20200409001952 NY Practitioner - Emergency MedicinePractitioner - Medical Toxicology 9739325416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Medical Toxicology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Weill Medical College of CornellGroup PAC ID 6800709023, 2,023 clinicians

Practice addresses (Care Compare)

525 E 68TH St
Emergency Physicians Dept
New York, NY 10021-4870
Phone (646) 962-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15313CAMDOptometrist
20A15313CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weill Medical College of Cornell Current Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2017 Accepting new patients
Weill Medical College of Cornell Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Usc Care Medical Group, Inc Family Medicine CurrentSince Jun 1, 2017 Accepting new patients

Locations

1812 Verdugo Blvd
Glendale, CA 91208
Phone (818) 246-8000

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

525 E 68th St
New York, NY 10065
Phone (212) 746-2846

Interoperability endpoints

  • Direct secure messaging: ecm9016@direct.nyp.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 5

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659668093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "818-790-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 VERDUGO BLVD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081407",
            "telephone_number": "818-790-7100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2545 Schoenersville Road",
            "address_2": "5th Floor South",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "18017",
            "country_code": "US",
            "telephone_number": "484-884-2888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT013975",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A15313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.