Individual provider Active NPI

Leslie Carol Moore, CRNP FNP

  • Primary Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1912424474
Registry record updated Aug 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
SP014903 Issued in PA
Practice address
1800 Lombard St
Philadelphia, PA 19146-1414
Phone
(215) 893-7310
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X SP014903 PA Primary

Addresses

Primary practice location

1800 Lombard St
Philadelphia, PA 19146-1414

Mailing address

1800 Lombard St
Philadelphia, PA 19146-1414
Phone (215) 893-7310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20190920000247 PA Practitioner - Nurse Practitioner 0749510519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Penn-Medical GroupGroup PAC ID 6204730955, 3,433 clinicians

Practice addresses (Care Compare)

1800 Lombard St
Suite 206
Philadelphia, PA 19146-1414
Phone (215) 615-2222

Merit-based Incentive Payment System (MIPS)

Final score
84.91 of 100Reported as group
Quality
73.58
Promoting interoperability
100
Improvement activities
40
Cost
76.13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn - Medical Group Current Accepting new patients
University of Penn-Medical Group CurrentSince Jul 2, 2019 Accepting new patients
University of Penn - Medical Group CurrentSince Jul 2, 2019 Accepting new patients

Locations

1800 Lombard St
Philadelphia, PA 19146
Phone (215) 545-4173

1800 Lombard St
Ste 206
Philadelphia, PA 19146
Phone (215) 615-2222

3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669

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.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503619200000",
    "number": "1912424474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461414",
            "telephone_number": "215-893-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LOMBARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461414",
            "telephone_number": "215-893-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LESLIE",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "CRNP FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2017-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP014903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.