Daniel J Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004846 Issued in MI

Practice address

6465 Millennium
Suite 100
Lansing, MI 48917-6880

Phone

(517) 975-3720

Fax

(517) 975-3748

NPI assigned

Mar 16, 2010

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

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Altea Medical Michigan PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Plymouth, MI
  • NPI 1053142000
  Medicare reassignment
• Post Acute Medical PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Lanham, MD
  • NPI 1730713025

  MI

  Medicare reassignment

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1821312174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638",
            "telephone_number": "810-342-1000",
            "fax_number": "810-342-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 MILLENNIUM",
            "address_2": "SUITE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489176880",
            "telephone_number": "517-975-3720",
            "fax_number": "517-975-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Moore, RSW
• Andrea Morgan Moore, BCBA
• Brian Elliot Moore
• Chelsea Moore
• Christopher Paul Moore, P.T.
• Karin Marie Moore, DDS
• Raelea Moore, P.T.
• Ryan Moore
• Sarah G Moore, LLMSW
• Shanay Moore

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.