RICHARD MOOSE (NPI# 1093726523) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093726523 |
| Entity Type | Individual |
| Full Name | RICHARD MOOSE |
| Credential | MD |
| Practice Address |
44 Pierrepont Ave Potsdam NY 13676-2200 |
| Mailing Address |
6968 State Highway 56 Potsdam NY 13676-3504 |
| Practice Telephone | 3152672377 |
| Practice Fax Number | 3152673260 |
| Mailing Telephone | 3152672377 |
| Mailing Fax Number | 3152673260 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2016-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 203760-1 | NY | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 203760-1 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
44 PIERREPONT AVE |
| City | POTSDAM |
| State | NY |
| Zip Code | 13676-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770500696 | Heather Anne Pike | Specialist/Technologist | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2006-07-16 |
| 1033601976 | Alexandra Berking | Specialist/Technologist | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2018-06-06 |
| 1669896171 | Brandi K. Kelley | Social Worker | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2014-02-05 |
| 1083948376 | Kristine Elizabeth Johnson | Specialist/Technologist | 44 Pierrepont Ave, Potsdam, NY 13676 | 2009-09-20 |
| 1487706917 | Suny Potsdam | Clinic/Center | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2007-01-17 |
| 1952480709 | Tracy Harcourt | Nurse Practitioner | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2006-11-03 |
| 1780767129 | Richard W. Williams | Psychologist | 44 Pierrepont Ave, Flagg 153, Potsdam, NY 13676-2200 | 2006-10-21 |
| 1679660336 | Suny Potsdam Student Health Services | Clinic/Center | 44 Pierrepont Ave, Student Health Services, Potsdam, NY 13676-2200 | 2006-10-06 |
| 1588751192 | Mary Elizabeth Rosenfeld | Nurse Practitioner | 44 Pierrepont Ave, Potsdam, NY 13676-2200 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170702 | Lucille D'agostino | Nurse Practitioner | 6805 State Highway 11, Potsdam, NY 13676 | 2020-07-02 |
| 1942851969 | Carrie E Sullivan | Counselor | 6956 Ny-56, Potsdam, NY 13676 | 2019-09-20 |
| 1508425786 | David M. Hurlbut Dds Pllc | Dentist | 145 1/2 Market Street, Suite A, Potsdam, NY 13676 | 2019-06-11 |
| 1609358902 | Sara Anne O'brian Polniak | Counselor | 20 Cottage Street, Potsdam, NY 13676 | 2018-09-04 |
| 1215451067 | Sunday Wright Smith | Advanced Practice Midwife | 34 Lawrence Avenue, Potsdam, NY 13676 | 2017-08-02 |
| 1992239891 | Michael Paul Wendell | Nurse Anesthetist, Certified Registered | Canton-potsdam Hospital, 50 Leroy Street, Potsdam, NY 13676 | 2017-04-18 |
| 1023561495 | Rocky Mountain Holdings, LLC | Ambulance | 150 Hatch Rd, Potsdam, NY 13676 | 2016-08-02 |
| 1942658398 | Samantha Lucas | Physician Assistant | 49 Lawrence, Urgent Care, Potsdam, NY 13676 | 2016-05-26 |
| 1205237880 | State Hearing and Audiology, PC | Audiologist-Hearing Aid Fitter | 6604 State Route 56, Potsdam, NY 13676 | 2014-09-15 |
| 1649607888 | Talia Elizabeth Foster | Acupuncturist | 22 Depot St. Suite 13, Potsdam, NY 13676 | 2013-10-02 |
| Find all providers in zip 13676 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134304363 | Alecia Acee Vanwagner | Family Medicine | 49 Lawrence Avuenue, Potsdam, NY 13676 | 2008-01-07 |
| 1871671123 | Eleanor Jeannette Leek | Family Medicine | 107 S Canton Rd, Potsdam, NY 13676-3165 | 2006-11-02 |
| 1295710358 | John Sparrow Duffy | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676 | 2005-12-13 |
| 1346239308 | Timothy K Atkinson | Family Medicine | 190 Outer Main St, Suite 102, Potsdam, NY 13676-2324 | 2005-10-20 |
| 1366891632 | Mallory Sprague | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676-1889 | 2016-06-08 |
| 1073994968 | Ashley Grimshaw | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676 | 2015-06-16 |
| 1720427347 | Emily Louise Wood | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676-1889 | 2013-06-17 |
| 1104068667 | Vineet Bansal | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676-1889 | 2009-03-30 |
| 1396909008 | Aaron E Fuller | Family Medicine | 49 Lawrence Ave, Potsdam, NY 13676-1889 | 2008-07-11 |
| 1790943918 | Terry Howland Knowles | Family Medicine | 50 Leroy St, Potsdam, NY 13676-1786 | 2008-05-23 |
| Find all providers in POTSDAM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.