NPIMap

Individual provider Active NPI

Connor Gary Moore, PA-C

  • Physician Assistant
  • Williamsport, PA
National Provider Identifier
1881589141
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA066804 Issued in PA
Practice address
700 High St
Williamsport, PA 17701-3100
Phone
(570) 321-1000
NPI assigned
Jun 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA066804 PA Primary

Addresses

Primary practice location

700 High St
Williamsport, PA 17701-3100

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900
Phone (570) 326-8723

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address UPMCHospitals@upmcdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250813000742 PA Practitioner - Physician Assistant 4082112503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-2181

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Upmc Wellsboro Hospital, Wellsboro, PA, CCN 391316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA066804PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Susquehanna Physician Services CurrentSince Aug 1, 2025 Accepting new patients
Susquehanna Physician Services CurrentSince Aug 1, 2025 Accepting new patients
Susquehanna Physician Services Past Accepting new patients

Locations

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: connor.g.moore@upmcdirect.com

Organizations & group practices 3

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 9

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": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1881589141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900",
            "telephone_number": "570-326-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HIGH ST",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177013100",
            "telephone_number": "570-321-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CONNOR",
        "middle_name": "GARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA066804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UPMCHospitals@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 Grant St Fl 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Williamsport, PA

Sources for this page

Verify at the official NPI Registry.