NPIMap

Individual provider Active NPI

Carolyn Shay Moore, MD

  • Family Medicine Physician
  • Colorado Springs, CO
National Provider Identifier
1881821296
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0057420 Issued in CO
Practice address
4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone
(719) 259-6566
NPI assigned
Jun 12, 2009
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01069299A IN
Family Medicine Physician 207Q00000X 125056768 IL
Family Medicine Physician 207Q00000X DR.0057420 CO Primary

Addresses

Primary practice location

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932

Mailing address

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918-2932
Phone (719) 259-6566

Other practice location 1

2877 E Fountain Blvd
Colorado Springs, CO 80910-2312
Phone (719) 454-6009

Other practice location 2

3210 N Academy Blvd Ste 1
Colorado Springs, CO 80917-5158
Phone (719) 733-3131

Other identifiers 1

IdentifierTypeStateIssuer
9000138729MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20190717003958 CO Practitioner - Family Practice 4587809454 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Southwestern Medical School at Dallas, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alpine Medical Group Colorado PLLCGroup PAC ID 1759743347, 101 clinicians
Flagship Medical GroupGroup PAC ID 4688050263, 6 clinicians

Practice addresses (Care Compare)

Denver, CO 80202
Phone (720) 728-5170

3210 N Academy Blvd
Suite 1
Colorado Springs, CO 80917-5158
Phone (719) 733-3131

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125056768ILMDFamily Medicine Physician
01069299AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alpine Medical Group Colorado PLLC Family Medicine CurrentSince Sep 28, 2025 Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine Current Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince May 1, 2023 Accepting new patients
Oak Street Health Physicians Group of Colorado, PLLC Family Medicine CurrentSince May 1, 2023 Accepting new patients
Flagship Medical Group CurrentSince Apr 1, 2025 Accepting new patients

Locations

2877 E Fountain Blvd
Colorado Springs, CO 80910
Phone (719) 454-6009

3210 N Academy Blvd
Ste 1
Colorado Springs, CO 80917
Phone (719) 591-4698

4380 Austin Bluffs Pkwy
Colorado Springs, CO 80918
Phone (719) 454-6010

999 17th St
Ste 500
Denver, CO 80202
Phone (720) 355-0539

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1881821296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809182932",
            "telephone_number": "719-259-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 AUSTIN BLUFFS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809182932",
            "telephone_number": "719-259-6566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2877 E Fountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809102312",
            "country_code": "US",
            "telephone_number": "719-454-6009",
            "fax_number": "719-258-1319",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3210 N Academy Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809175158",
            "country_code": "US",
            "telephone_number": "719-733-3131",
            "fax_number": "719-463-0295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAROLYN",
        "middle_name": "SHAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01069299A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125056768",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0057420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000138729",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.