DR. NICHOLAS VENCENZO MOORE DO
NPI 1104492529
Internal Medicine in Wyandotte, MI

Q: What is Nicholas Moore's NPI number?

The NPI number for Nicholas Moore is 1104492529. It was assigned to this individual provider in the NPPES registry on May 27, 2021.

Q: What is Nicholas Moore's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicholas Moore was last updated on August 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since May 27, 2021PECOS EnrolledAccepts Medicare Assignment

2333 BIDDLE AVE, WYANDOTTE, MI 48192(734) 246-6000 Get Directions Write a Review

NPPES record last updated: August 5, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 5, 2024, May 27, 2021 (2 updates tracked since 2021).

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About Dr. Nicholas Vencenzo Moore Do NPPES

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

DR. NICHOLAS VENCENZO MOORE DO (NPI 1104492529) is an individual internal medicine provider in Wyandotte, Michigan, licensed in Michigan (5101028264) and active in the NPI registry since May 2021. He is enrolled in Medicare PECOS, is affiliated with Ascension Providence Hospital, Southfield And Novi, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1104492529

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. NICHOLAS VENCENZO MOORECredential: DO

Location Address2333 BIDDLE AVEWyandotte, MI 48192-4668

Mailing Address2923 Sparta DrTroy, MI 48083-6406 · (586) 850-4026

Phone(734) 246-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateMay 27, 2021

Last NPPES UpdateAugust 5, 20242 updates tracked since enumeration

NPPES CertifiedAugust 5, 2024

✔ NPI 1104492529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MI · 5101028264

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2333 BIDDLE AVE, Wyandotte, MI 48192

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicholas Vencenzo Moore Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587056395

PECOS Enrollment IDI20240925001741

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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

17 services17 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Ascension Providence Hospital, Southfield And Novi

Acute Care Hospitals · Southfield, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230019

Location16001 W Nine Mile RdSouthfield, MI 48075 · Oakland County

Emergency services Birthing friendly

Henry Ford Health Wyandotte Hospital

Acute Care Hospitals · Wyandotte, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230146

Location2333 Biddle AveWyandotte, MI 48192 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48192 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

$134.28 typical visit price

range $58.04 – $177.36

Typical copayment $33.57 (range $14.51 – $44.34)

Most-billed visit code 99204

Established Patient

$102.35 typical visit price

range $18.32 – $143.49

Typical copayment $25.58 (range $4.58 – $35.87)

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 20

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

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