Individual provider Active NPI

William V Moore, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
National Provider Identifier
1972556652
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
D63266 Issued in MD
Practice address
600 N Wolfe St
Baltimore, MD 21287-0005
Phone
(410) 532-4701
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X D63266 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Baltimore, MD 21287-0005

Mailing address

PO Box 64407
Baltimore, MD 21264-4407
Phone (410) 532-4250

Other identifiers 1

IdentifierTypeStateIssuer
409211200MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE)

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20061016000513 CA Practitioner - Physical Medicine and RehabilitationPractitioner - Other (Physician) 3577583905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Tulane University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Phone (510) 248-3000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Physical Medicine & Rehabilitation CurrentSince Oct 20, 2010 Accepting new patients
Permanente Medical Group Inc Physical Medicine & Rehabilitation Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Oct 20, 2010 Accepting new patients

Locations

39400 Paseo Padre Pkwy
Fremont, CA 94538
Phone (510) 248-3000

39350 Civic Center Dr
Ste 300
Fremont, CA 94538
Phone (510) 797-3933

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1972556652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64407",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644407",
            "telephone_number": "410-532-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-532-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WILLIAM",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "D63266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "409211200",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "39400 Paseo Padre Pkwy",
            "city": "Fremont",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945382310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.