Nicole K Moore, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA1477 Issued in ME

Practice address

992 Union St Ste 5
Bangor, ME 04401-3057

Phone

(207) 992-2601

Fax

(207) 404-8351

NPI assigned

Jun 27, 2014

Last updated

May 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME, NH2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

York HospitalGroup PAC ID 6406766781, 202 clinicians

Rehabilitation Associates PCGroup PAC ID 2466743992, 14 clinicians

Maine Medical Consultants PCGroup PAC ID 7810229259, 46 clinicians

Pai Participant 7 PCGroup PAC ID 2466788906, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• York Hospital Hospital, York, ME, CCN 200020

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maine Medical Consultants PC

  • Internal Medicine Physician
  • Portland, ME
  • NPI 1619519873
  Medicare reassignment Care Compare group
• Pai Participant 7 PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Falmouth, ME
  • NPI 1548829872
  Medicare reassignment Care Compare group
• Rehabilitation Associates PC

  dba Rehabilitation Medical Consultants

  • Physical Medicine & Rehabilitation Physician
  • Portland, ME
  • NPI 1629430087

  NH

  Medicare reassignment Care Compare group
• York Hospital

  • General Acute Care Hospital
  • York, ME
  • NPI 1376528398
  Medicare reassignment Care Compare group
• Bluewater Emergency Partners of Brunswick, LLC

  • Emergency Medicine Physician
  • Brunswick, ME
  • NPI 1043640204
  Medicare reassignment NPD
• Eastern Maine Medical Center

  • General Acute Care Hospital
  • Bangor, ME
  • NPI 1790789147
  Medicare reassignment
• Eastern Maine Medical Center

  • Rehabilitation Hospital Unit
  • Bangor, ME
  • NPI 1780674689
  NPD
• Seacoast Pathology Inc

  • Clinical Medical Laboratory
  • Exeter, NH
  • NPI 1154651230
  NPD

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

• York Hospital

  • General Acute Care Hospital
  • York, ME
  • NPI 1376528398
  Care Compare affiliation

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1679988737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1599",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044021599",
            "telephone_number": "207-404-8200",
            "fax_number": "207-947-0435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 UNION ST STE 5",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013057",
            "telephone_number": "207-992-2601",
            "fax_number": "207-404-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "489 State St",
            "address_2": "Kelly 6",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "04401",
            "country_code": "US",
            "telephone_number": "207-973-6605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 Whiting Hill Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Brewer",
            "state": "ME",
            "postal_code": "044121006",
            "country_code": "US",
            "telephone_number": "207-973-4266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICOLE",
        "middle_name": "K",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA1477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan C Moore, DNP
• Madison Rose Moore
• Marsha A. Moore
• Mary D Moore, LCSW
• Mary R Moore, CRNA
• Robert Danny Moore, DDS, MD
• Melinda Rae Moran, RDH
• Renee Marie Moran, P.T.
• Kathryn Marie Mordino, ANP-BC
• More Than Therapy LLC

• Medical Physician Assistant in Bangor, ME
• Providers in Bangor, ME by specialty
• Medical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.