Individual provider Active NPI

Lawrence M Moore, MD

  • Family Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1699235598
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
74437-20 Issued in WI
Practice address
5818 W Capitol Dr
Milwaukee, WI 53216-2247
Phone
(414) 449-2114
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 74437-20 WI Primary

Addresses

Primary practice location

5818 W Capitol Dr
Milwaukee, WI 53216-2247

Mailing address

3301 W Forest Home Ave
Milwaukee, WI 53215-2843
Phone (414) 449-2114

Other practice location 1

2900 W Oklahoma Ave
Milwaukee, WI 53215-4330
Phone (414) 649-6732

Other identifiers 1

IdentifierTypeStateIssuer
100161086MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lmoore183956@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220916003094 WI Practitioner - Family Practice 0749698686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

5818 W Capitol Dr
Milwaukee, WI 53216-2247
Phone (414) 449-2114

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74437-20WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Oct 23, 2022 Accepting new patients
Aurora Medical Group, Inc. Family Medicine CurrentSince Oct 23, 2022 Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Oct 23, 2022 Accepting new patients
Aurora Health Care Metro, Inc. Family Medicine CurrentSince Oct 23, 2022 Accepting new patients

Locations

2801 W Kinnickinnic River Pkwy
Ste 250
Milwaukee, WI 53215
Phone (414) 649-3354

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

5818 W Capitol Dr
Milwaukee, WI 53216
Phone (414) 447-8071

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1699235598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W FOREST HOME AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532152843",
            "telephone_number": "414-449-2114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 W CAPITOL DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162247",
            "telephone_number": "414-449-2114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154330",
            "country_code": "US",
            "telephone_number": "414-649-6732",
            "fax_number": "414-649-5840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAWRENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "74437-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100161086",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmoore183956@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5818 W Capitol Dr",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532162247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "5818 W Capitol Dr",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532162247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.