Individual provider Active NPI

Rosa Cheree Moore, MD

  • Emergency Medicine Physician
  • Austintown, OH
National Provider Identifier
1992201842
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.141492 Issued in OH
Practice address
6252 Mahoning Ave
Austintown, OH 44515-2003
Phone
(240) 686-2300
NPI assigned
Mar 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 35.141492 OH Primary

Addresses

Primary practice location

6252 Mahoning Ave
Austintown, OH 44515-2003

Mailing address

329 Sanctuary Dr
Cortland, OH 44410-8816

Other practice location 1

4201 Saint Antoine, UHC 9C
Detroit, MI 48201
Phone (313) 993-0034

Other names 1

  • Rosa Tolomello Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220805002826 MI Practitioner - Emergency Medicine 3072878339 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Michigan Emergency Services, PCGroup PAC ID 1456265891, 69 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

601 John St
Kalamazoo, MI 49007-5341
Phone (269) 341-7654

940 John St
Kalamazoo, MI 49001-2857
Phone (269) 552-4266

Hospital & facility affiliations

  • Bronson Methodist Hospital Hospital, Kalamazoo, MI, CCN 230017
  • Bronson Battle Creek Hospital Hospital, Battle Creek, MI, CCN 230075
  • Bronson Lakeview Hospital Hospital, Paw Paw, MI, CCN 231332
  • Bronson South Haven Hospital Hospital, South Haven, MI, CCN 230085

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

Merit-based Incentive Payment System (MIPS)

Final score
93.26 of 100Reported as group
Quality
79.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Michigan Emergency Services, PC CurrentSince Aug 1, 2022 Accepting new patients
Bronson Methodist Hospital CurrentSince Jul 1, 2024 Accepting new patients

Locations

300 North Ave
Battle Creek, MI 49017
Phone (269) 966-8000

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

940 John St
Kalamazoo, MI 49001
Phone (269) 343-7296

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

408 Hazen St
Paw Paw, MI 49079
Phone (269) 341-8481

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1992201842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 SANCTUARY DR",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444108816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6252 MAHONING AVE",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152003",
            "telephone_number": "240-686-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine, UHC 9C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48201",
            "country_code": "US",
            "telephone_number": "313-993-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROSA",
        "middle_name": "CHEREE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-31",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.141492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "TOLOMELLO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austintown, OH

Sources for this page

Verify at the official NPI Registry.