Susan J Moore, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD044660E Issued in PA

Practice address

4247 W Ridge Rd Ste 105
Erie, PA 16506-1746

Phone

(814) 838-2468

Fax

(814) 835-2599

NPI assigned

Dec 14, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoore149318@direct.ahn.org

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.

• St Vincent Medical Education and Research Institute Inc

  • Internal Medicine Physician
  • Erie, PA
  • NPI 1902881477

  Pediatrics

  Medicare reassignment NPD
• Saint Vincent Medical Education and Research Institute

  • Family Medicine Physician
  • Albion, PA
  • NPI 1558462259
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1912982661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061746",
            "telephone_number": "814-838-2468",
            "fax_number": "814-835-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4247 W RIDGE RD STE 105",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061746",
            "telephone_number": "814-838-2468",
            "fax_number": "814-835-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD044660E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoore149318@direct.ahn.org",
            "affiliation": "N",
            "address_1": "4247 W Ridge Rd Ste 105",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165061746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cindy Kay Moore, M.A.
• Dawn Marie Moore, PHARM D.
• Hannah Moore
• Michael Thomas Moore, DMD
• Shannon Moore
• Angel Mora
• Moral Home Care LLC
• Rafael Angel Morales, MD
• Jamie L Moraski, RD,LDN
• Mary W Moreland, CRNP

• Pediatrics Physician in Erie, PA
• Providers in Erie, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.