Individual provider Active NPI

Elizabeth Moreno, FNP-C

  • Family Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1962090522
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704273355 Issued in MI
Practice address
505 N Clippert St
Lansing, MI 48912-4701
Phone
(517) 999-2273
NPI assigned
Jan 8, 2021
Last updated
Jan 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704273355 MI Primary

Addresses

Primary practice location

505 N Clippert St
Lansing, MI 48912-4701

Mailing address

1641 Birchwood Dr
Okemos, MI 48864-2907
Phone (517) 203-9059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210413000466 MI Practitioner - Nurse Practitioner 4981012929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lansing Urgent Care PLCGroup PAC ID 7214947902, 42 clinicians

Practice addresses (Care Compare)

505 N Clippert St
Lansing, MI 48912-4701
Phone (517) 333-9200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Urgent Care PLC CurrentSince Jan 12, 2021 Accepting new patients
Meridian Wellness, PLLC Past Accepting new patients
Lansing Urgent Care, PLC PastSince Jan 10, 2021 Accepting new patients

Locations

12970 S US Highway 27
Dewitt, MI 48820
Phone (517) 669-8345

320 E Jolly Rd
Lansing, MI 48910
Phone (517) 999-4700

4440 W Saginaw Hwy
Lansing, MI 48917
Phone (517) 327-6400

505 N Clippert St
Lansing, MI 48912
Phone (517) 285-0905

2289 W Grand River Ave
Okemos, MI 48864
Phone (517) 349-2300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1962090522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 BIRCHWOOD DR",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642907",
            "telephone_number": "517-203-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N CLIPPERT ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124701",
            "telephone_number": "517-999-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704273355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.