Glenn Keith Moran, DO,FACOFP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS5696 Issued in FL

Practice address

201 NW 82ND Ave
Plantation, FL 33324-1856

Phone

(954) 472-5100

Fax

(954) 472-5266

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Hospital West Hospital, Pembroke Pines, FL, CCN 100281
• Boca Raton Regional Hospital Hospital, Boca Raton, FL, CCN 100168
• HCA Florida University Hospital Hospital, Davie, FL, CCN 100360
• Westside Regional Medical Center Hospital, Plantation, FL, CCN 100228

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: plfmed@pfma-fl.direct.office.nextgen.com

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.

• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

• Boca Raton Regional Hospital, Inc.

  • General Acute Care Hospital
  • Boca Raton, FL
  • NPI 1902826779
  Care Compare affiliation
• Columbia Hospital Corporation of South Broward

  • General Acute Care Hospital
  • Plantation, FL
  • NPI 1063466589
  Care Compare affiliation
• Davie Medical Center, LLC

  • General Acute Care Hospital
  • Davie, FL
  • NPI 1871182956
  Care Compare affiliation
• South Broward Hospital District

  • General Acute Care Hospital
  • Pembroke Pines, FL
  • NPI 1134102080
  Care Compare affiliation

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801850672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 SW 135TH TER",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333304647",
            "telephone_number": "954-472-5100",
            "fax_number": "954-472-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NW 82ND AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241856",
            "telephone_number": "954-472-5100",
            "fax_number": "954-472-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "GLENN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "DO,FACOFP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80509",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "971681",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moon Health Care Inc
• Elizabeth Ann Moore
• Amanda Sofia Morales Rivera
• Milagros J Morales
• Myra Karina Morales, MD
• George Morar, MD
• Raquel Morciego
• Nicole Lynn Moreau, MD
• Rhiannon Morejon, APRN
• Sandy D Morel, RN

• Family Medicine Physician in Plantation, FL
• Providers in Plantation, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.