DR. BROOKE CAROL MOORE (NPI# 1205833704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205833704 |
| Entity Type | Individual |
| Full Name | DR. BROOKE CAROL MOORE |
| Credential | M.D. |
| Practice Address |
2500 Route 347 Bldg 14a Stony Brook NY 11790-2554 |
| Mailing Address |
1500 Route 112 Ste 101 Port Jefferson Station NY 11776-8054 |
| Practice Telephone | 6316897800 |
| Practice Fax Number | 6316893016 |
| Mailing Telephone | 6317513000 |
| Mailing Fax Number | 6315096559 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2019-09-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
161222 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | HEALTHNET | 0C3233 | 01 |
| NM | MEDICARE RAIL ROAD | 390001418 | 01 |
| NY | OXFORD | CS629 | 01 |
| NY | 01130890 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437546769 | Brooke Nicole Moore | Counselor | 367 W Chicken Fight Rd, Atoka, OK 74525-4110 | 2015-04-24 |
| 1316570815 | Brooke Moore | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-02-13 |
| 1821643685 | Brooke Moore | Physical Therapist | 1217 Plaza Blvd Ste E, Central Point, OR 97502-2682 | 2019-08-07 |
| 1043791635 | Brooke Moore | Nurse Practitioner | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2018-08-22 |
| 1992156673 | Brooke Moore | Social Worker | 3175 Professional Ct, Bay City, MI 48706-2823 | 2016-06-23 |
| 1184085268 | Brooke Moore | Nurse Practitioner | 2413 N Meridian St, Indianapolis, IN 46208-5854 | 2016-03-16 |
| 1477925881 | Brooke Moore | Specialist/Technologist | 1805 W Heavenly Ct, Flagstaff, AZ 86001-2836 | 2015-10-24 |
| 1770910994 | Brooke Ann Moore | Student in an Organized Health Care Education/Training Program | 3870 Rosin Ct Ste 130, Sacramento, CA 95834-1647 | 2013-10-02 |
| 1235416579 | Brooke G Moore | Counselor | 601 S Edwin C Moses Blvd, 4th Floor, Nw Building, Dayton, OH 45417-3424 | 2011-11-15 |
| 1336474451 | Brooke A Moore | Social Worker | 55 Westchester Sq, Bronx, NY 10461-3525 | 2009-10-07 |
| Street Address |
2500 ROUTE 347 BLDG 14A |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11790-2554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699025635 | Elyse S Rafal M D P C | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2012-09-18 |
| 1457609372 | Mark D Epstein M D P C | Specialist | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2012-08-27 |
| 1356615504 | Kelly Jocelyn Kreis | Registered Nurse | 2500 Route 347, Suite 8d, Stony Brook, NY 11790-2555 | 2012-03-06 |
| 1841396546 | Amy Wishner Steinberg | Dermatology | 2500 Route 347, Bldg 5a Amy Wishner Steinberg Md, Stony Brook, NY 11790-2555 | 2006-09-16 |
| 1578575304 | Horia Liviu Vlase | Internal Medicine | 2500 Route 347, Bldg 14a, Stony Brook, NY 11790-2554 | 2006-08-12 |
| 1710909502 | Mark L Bernstein | Internal Medicine | 2500 Route 347, Bldg 8d, Stony Brook, NY 11790 | 2006-07-24 |
| 1245271600 | Ophthalmic Consultants of Long Island | Ophthalmology | 2500 Route 347, Building 24a, Stony Brook, NY 11790-2555 | 2006-06-09 |
| 1255393567 | Mark D Epstein | Plastic Surgery | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2006-04-03 |
| 1477515781 | Elyse S. Rafal | Dermatology | 2500 Route 347, Building 22a, Stony Brook, NY 11790-2555 | 2006-04-03 |
| 1184614935 | Trevor S Wong | Physical Therapist | 2500 Route 347, Suite 8d, Stony Brook, NY 11790-2555 | 2005-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649807678 | Ribu Mathew | Student in an Organized Health Care Education/Training Program | Health Science Center T16, Room 020, Stony Brook, NY 11790 | 2020-03-27 |
| 1538794821 | Chaoyang Qu | Student in an Organized Health Care Education/Training Program | 9 Syncamore Dr, Stonybrook, NY 11790 | 2020-03-06 |
| 1457814824 | Brain & Spine Surgery, P.C. | Neurological Surgery | 2500 Nesconset Hwy., Bldg 18c, Stony Brook, NY 11790 | 2019-04-11 |
| 1447759741 | Susan Cuccia | Registered Nurse | 40 Sheppard Lane, Stony Brook, NY 11790 | 2018-02-02 |
| 1972022234 | Carol M Doherty | Specialist | 7 Haskel Lane, Stony Brook, NY 11790 | 2017-09-18 |
| 1972021582 | Louren M Gonzales | Nurse Practitioner | 100 Nicolls Rd Hsc Level 4 Room 120, Hsc Level 4 Room 120, Stony Brook, NY 11790 | 2017-09-04 |
| 1043740954 | Asma Khattak | Behavior Technician | 90 Quaker Path, Stony Brook, NY 11790 | 2017-06-13 |
| 1427452846 | Christina Georgia | Registered Nurse | 36 Ivy League Lane, Stony Brook, NY 11790 | 2014-10-14 |
| 1124361654 | Mandeep Kainth | Student in an Organized Health Care Education/Training Program | Department of Medicine Hsc Level 16, 020, Suny Stony Brook, Stony Brook, NY 11790 | 2013-04-03 |
| 1922357144 | Audry M Luciano | Registered Nurse | 2500 Nesconset Hwy Bldg 23, Stony Brook, NY 11790 | 2012-09-04 |
| Find all providers in zip 11790 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760610554 | Yezina Temesgen Nigatu | Internal Medicine | Hsct T16 080, Stony Brook, NY 11794-8166 | 2009-06-30 |
| 1720221971 | Chelsea Estrada | Internal Medicine | Stony Brook Internists Ufpc, Hsc T16-080, Stony Brook, NY 11794-8166 | 2009-04-16 |
| 1063687929 | Kyung Ho Kim | Internal Medicine | Dept of Medicine Stony Brook University, Health Sciences Center Level 16 Rm 020, Stony Brook, NY 11794-0001 | 2008-04-23 |
| 1710998182 | Claudio Martincic | Internal Medicine | 2500 Nesconset Hwy Bldg 14a, Stony Brook, NY 11790-2554 | 2006-08-11 |
| 1184621500 | Mitchell G Kirsch | Internal Medicine | 2500 Route 347 Bldg 14a, Stony Brook, NY 11790-2554 | 2005-06-30 |
| 1790180776 | Rula Abdulrahman | Internal Medicine | 101 Nicolls Rd, Stony Brook, NY 11794-4423 | 2014-11-03 |
| 1578575304 | Horia Liviu Vlase | Internal Medicine | 2500 Route 347, Bldg 14a, Stony Brook, NY 11790-2554 | 2006-08-12 |
| 1215976337 | Stony Brook Internists, University Faculty Practice Corporation | Internal Medicine | Suny @ Stony Brook, Hsc, L16, Rm 020, Stony Brook, NY 11794-0001 | 2006-06-05 |
| 1700887924 | Nicolae S Caraiani | Internal Medicine | 2500 Route 347, Building 14a, Stony Brook, NY 11790-2554 | 2005-08-10 |
| 1508866492 | Suffolk Nephrology Consultants PC | Internal Medicine | 2500 Route 347, Bldg 14a, Stony Brook, NY 11790-2555 | 2005-07-21 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11790 |
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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.