Ellen Moore, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4351027347 Issued in MI

Practice address

3912 32ND Ave
Hudsonville, MI 49426-8460

Phone

(616) 252-8700

Fax

(616) 252-8750

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Michigan State University College of Human Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metropolitan HospitalGroup PAC ID 5597651836, 421 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236
• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Metropolitan Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment Care Compare group NPD
• Metropolitan Hospital

  • Family Medicine Physician
  • Wyoming, MI
  • NPI 1114947538
  NPD (past)
• Metropolitan Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Wyoming, MI
  • NPI 1336182542
  NPD (past)

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

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  Care Compare affiliation
• Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1992299515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3912 32ND AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268460",
            "telephone_number": "616-252-8700",
            "fax_number": "616-252-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3912 32ND AVE",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268460",
            "telephone_number": "616-252-8700",
            "fax_number": "616-252-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301115010",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351027347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Mlynarek, D.O.
• Carly N Molenkamp
• Janette Molenkamp
• Tina Marie Monahon, MA, CCC-SLP, CBIS
• Carolyn Diane Moore, MA, CCC-SLP
• Amy Elizabeth Mulder, PA-C
• New Pathways Counseling, LLC.
• Sally D Ngo, PHARM.D
• Anna Nguyen
• Brooke Nicholson, LLC

• Family Medicine Physician in Hudsonville, MI
• Providers in Hudsonville, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.