NPIMap

Individual provider Active NPI

Cheryl L Moore, MD

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1861484289
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301048412 Issued in MI
Practice address
21700 Northwestern Hwy
600
Southfield, MI 48075-4906
Phone
(248) 559-6664
Fax
(248) 559-5628
NPI assigned
Aug 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301048412 MI Primary

Addresses

Primary practice location

21700 Northwestern Hwy
600
Southfield, MI 48075-4906

Mailing address

25925 Telegraph Rd
210
Southfield, MI 48034-2518
Phone (248) 746-0342

Other identifiers 1

IdentifierTypeStateIssuer
352153010MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000436 MI Practitioner - Internal Medicine 6507920063 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Wayne State University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Medical Centre PCGroup PAC ID 5597668947, 13 clinicians

Practice addresses (Care Compare)

22711 Grand River Ave
Suite 100
Detroit, MI 48219-3113
Phone (313) 221-9189

Hospital & facility affiliations

  • Beaumont Home Health Home health agency, Troy, MI, CCN 237112
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan Internal Medicine CurrentSince Jan 1, 2011 Accepting new patients
Kamran F. Sheikh MD PC Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Henry Ford Health Providence Hospital Past Accepting new patients
Halo Tele-Joy PLLC Internal Medicine Past Accepting new patients
DMC Orthopedic Billing Associates LLC Past Accepting new patients

Locations

22711 Grand River Ave
Ste 100
Detroit, MI 48219
Phone (313) 221-9189

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

6001 W Outer Dr
Ste 205
Detroit, MI 48235
Phone (313) 966-1045

26750 Providence Pkwy
Novi, MI 48374
Phone (248) 465-4782

29201 Telegraph Rd
Ste 404
Southfield, MI 48034
Phone (248) 355-0880

16001 W 9 Mile Rd
Fl 5
Southfield, MI 48075
Phone (248) 380-4335

Interoperability endpoints

  • Direct secure messaging: cheryl.moore.1@24172.direct.athenahealth.com

Organizations & group practices 6

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 5

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": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1861484289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25925 TELEGRAPH RD",
            "address_2": "210",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480342518",
            "telephone_number": "248-746-0342",
            "fax_number": "248-746-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21700 NORTHWESTERN HWY",
            "address_2": "600",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754906",
            "telephone_number": "248-559-6664",
            "fax_number": "248-559-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHERYL",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-22",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301048412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "352153010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.