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MICHELLE MOORE
NPI 1043769268
Nurse Practitioner - Primary Care in New York, NY

Active since September 29, 2016PECOS Enrolled
632 BROADWAY PH 12, NEW YORK, NY 10012(347) 294-3414(205) 332-1383 Get Directions Write a Review

NPPES record last updated: September 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 5, 2022, Nov 7, 2016, Sep 29, 2016 (3 updates tracked since 2016).

About Michelle Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHELLE MOORE (NPI 1043769268) is an individual primary care provider in New York, New York, licensed in Illinois (209.014876) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1043769268
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameMICHELLE MOORE
Location Address632 BROADWAY PH 12New York, NY 10012-2614
Mailing Address632 Broadway Ph 12New York, NY 10012-2614 · (347) 294-3414 · Fax (205) 332-1383
Phone(347) 294-3414
Fax(205) 332-1383
Sole ProprietorYes
Enumeration DateSeptember 29, 2016
Last NPPES UpdateSeptember 5, 20223 updates tracked since enumeration
NPPES CertifiedSeptember 5, 2022
✔ NPI 1043769268 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in IL · 209.014876
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 209.014876 (IL)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 209.014876 (IL)
632 BROADWAY PH 12, New York, NY 10012
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Secondary Practice Location 1

Location 1458 N May StChicago, IL 60642-5819 · Phone (312) 810-8896

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michelle Moore is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10012 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$114.88 typical visit price
range $21.20 – $160.66
Typical copayment $28.72 (range $5.30 – $40.16)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIKA SURACE M.D.
Family Medicine
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 943-8131
GALILEO MEDICAL GROUP ME, PC
Family Medicine
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 588-0601
PETER YONG-KYU KIM M.D.
Family Medicine
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 294-3414
GALILEO MEDICAL GROUP GA, P.C.
Family Medicine
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 588-0601
DIANA CHIA CRNP
Nurse Practitioner (Primary Care)
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 294-3414
KRISTEN MARY PALLEO FNP-BC
Nurse Practitioner (Family)
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 294-3414
ARACELI THEODORE
Nurse Practitioner (Gerontology)
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 294-3414
CYNTHIA U INE FNP-C
Nurse Practitioner (Family)
632 BROADWAY PH 12
NEW YORK, NY 10012
New York County (347) 294-3414

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michelle Moore's NPI number?

The NPI number for Michelle Moore is 1043769268. It was assigned to this individual provider in the NPPES registry on September 29, 2016.

Where is Michelle Moore located?

Michelle Moore practices at 632 Broadway Ph 12, New York, NY 10012. The listed phone number is (347) 294-3414.

What is Michelle Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Michelle Moore enrolled in Medicare?

Yes. Michelle Moore is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Michelle Moore was last updated on September 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.