Individual provider Active NPI

Christopher Leonard Moore, MD

  • Emergency Medicine Physician
  • New Haven, CT
National Provider Identifier
1679554240
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
040571 Issued in CT
Practice address
20 York St
Ynhh South Pavilion - Room 218
New Haven, CT 06510-3220
Phone
(203) 688-2222
Fax
(203) 785-4580
NPI assigned
Nov 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 040571 CT Primary

Addresses

Primary practice location

20 York St
Ynhh South Pavilion - Room 218
New Haven, CT 06510-3220

Mailing address

20 York St
Ynhh South Pavilion - Room 218
New Haven, CT 06510-3220
Phone (203) 688-2222

Other identifiers 1

IdentifierTypeStateIssuer
001405712MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, VT2 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
I20050603000408 CT Practitioner - Emergency MedicinePractitioner - Internal Medicine 5092758797 Reassigns benefits to 1 organization
I20160826001777 VT Practitioner - Emergency Medicine 5092758797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Virginia School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yale UniversityGroup PAC ID 9436061736, 2,632 clinicians

Practice addresses (Care Compare)

20 York St
New Haven, CT 06510-3220
Phone (203) 785-4638

Hospital & facility affiliations

  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
040571CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rutland Hospital, Inc Emergency Medicine CurrentSince Jun 15, 2016 Accepting new patients
Rutland Hospital, Inc. CurrentSince Jun 15, 2016 Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Sep 1, 2023 Accepting new patients

Locations

100 Hospital Dr
Bennington, VT 05201
Phone (802) 447-4509

120 Hospital Dr
Bennington, VT 05201
Phone (802) 440-4077

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

160 Allen St
Rutland, VT 05701

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6f43d0e7-6ff2-489b-abdc-44e8a5e0ca0a/
  • Direct secure messaging: cmoore4038@direct.ynhh.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 2

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": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1679554240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YNHH SOUTH PAVILION - ROOM 218",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2222",
            "fax_number": "203-785-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "YNHH SOUTH PAVILION - ROOM 218",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2222",
            "fax_number": "203-785-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "040571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001405712",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.