MICHAEL DAVID MOORE (NPI# 1366521759) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366521759 |
| Entity Type | Individual |
| Full Name | MICHAEL DAVID MOORE |
| Credential | M.D. |
| Practice Address |
5792 Widewaters Pkwy Ste 101 Syracuse NY 13214-1847 |
| Practice Telephone | 3154224412 |
| Mailing Telephone | 3154224412 |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2019-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 207748 | NY | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | G85428 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | INTERPLAN | 49516 | 01 |
| CA | 00G854280 | 05 | |
| CA | GREAT WEST | 1392936 | 01 |
| CA | CIGNA | 2700475 | 01 |
| CA | AETNA | 7429234 | 01 |
| CA | PACIFICARE | 90121857 | 01 |
| CA | BLUE CROSS | G85428 | 01 |
| CA | WESTERN HEALTH ADVANTAGE | MCMG170200 | 01 |
| CA | BLUE SHIELD | 00G854280 | 01 |
| NY | 01852235 | 05 | |
| CA | UNITED HEALTHCARE | 1767577 | 01 |
| CA | FIRST HEALTH | 2258848 | 01 |
| CA | FIRST HEALTH | 937998 | 01 |
| CA | PHCS | 000001620745 | 01 |
| CA | HEALTH NET | 089071 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972115582 | Michael Shane Moore | Physical Medicine & Rehabilitation | 2757 Vandy Ct, Montgomery, AL 36110-1339 | 2020-08-17 |
| 1225659519 | Michael Thomas Moore | Counselor | 920 Belview St. Se, Washington, DC 20032 | 2020-04-28 |
| 1508327537 | Michael D Moore | Nurse Practitioner | 1012 Center Dr, Richmond, KY 40475-3838 | 2019-03-31 |
| 1407393846 | Michael Charles Moore | Counselor | 2123 W 77th St, Los Angeles, CA 90047-2312 | 2017-01-24 |
| 1356884852 | Michael Lemuel Moore II | Counselor | 665 Rotunda Way, Brentwood, CA 94513-5534 | 2016-12-01 |
| 1154778355 | Michael Moore | Pharmacist | 10604 Hinderhill Dr, Bakersfield, CA 93312-7038 | 2016-05-17 |
| 1750747564 | Michael Moore | Developmental Therapist | 220 Pebble Creek Rd, Powell, WY 82435-2271 | 2016-01-08 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1558742734 | Michael B Moore | Nurse Practitioner | 3040 College St, Beaumont, TX 77701-4606 | 2015-06-14 |
| 1033517578 | Michael D. Moore | Hearing Instrument Specialist | 11834 County Road 101, Suite 202, The Villages, FL 32162 | 2014-12-16 |
| Street Address |
5792 WIDEWATERS PKWY STE 101 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13214-1847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112487 | Charles Teitelbaum | Ophthalmology | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2005-05-31 |
| 1336709518 | Stacey Lorraine Nutting | Technician/Technologist | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2019-06-19 |
| 1578852992 | Katharine Liegel | Ophthalmology | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2011-04-06 |
| 1417142837 | Scott J Bushinger | Optometrist | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2007-09-10 |
| 1538362058 | Anthony Francis Devincentis IIi | Ophthalmology | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2007-06-11 |
| 1912014200 | Walter Woodhull Merriam | Ophthalmology | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2006-08-24 |
| 1568578920 | Eye Consultants of Syracuse PC | Optometrist | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881108983 | Nathan Fowler | Dentist | 3469 Erie Blvd E # 3a, Syracuse, NY 13214 | 2017-11-28 |
| 1841716875 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3649 Erie Blvd E Ste 215b, Syracuse, NY 13214 | 2017-08-22 |
| 1124568993 | Jose Alvarez | Dentist | 3425 Erie Blvd E Ste 1, De Witt, NY 13214 | 2017-02-27 |
| 1205258365 | Margaret Miller | Social Worker | 4101 E. Genesee St, Syracuse, NY 13214 | 2014-01-09 |
| 1124367669 | Marni Marie Millet | Counselor | 4309 E Genesee St Ste 4, Syracuse, NY 13214 | 2013-02-04 |
| 1477817401 | Runa Acharya | Internal Medicine | 3229 East Genesee St, Syracuse, NY 13214 | 2012-06-25 |
| 1487949913 | Angela Patricia Mojica Sanabria | Pediatrics | 3229 East Genesee St Ste 1, Syracuse, NY 13214 | 2011-06-13 |
| 1346530169 | Affinity Rehabilitation LLP | Clinic/Center | 18 Arbor Lane, Dewitt, NY 13214 | 2011-04-13 |
| 1003105768 | David William Hansen | Pediatrics | 3229 E. Genesee St, Suite 1, Syracuse, NY 13214 | 2011-04-04 |
| 1558676411 | Jamesville-dewitt Central School District | Local Education Agency (LEA) | Edinger Drive, Dewitt, NY 13214 | 2010-08-16 |
| Find all providers in zip 13214 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265590103 | Childrenseye Care Physicians of Cny, LLC | Ophthalmology | 1810 Erie Blvd E, Syracuse, NY 13210-1230 | 2006-12-04 |
| 1477653657 | Ann Barker-griffith | Ophthalmology | 550 Harrison St Ste 340, Syracuse, NY 13202-3064 | 2006-09-25 |
| 1063462133 | Michael J Geiss IIi | Ophthalmology | 2215 E Genesee St, Syracuse, NY 13210-2219 | 2006-05-11 |
| 1013984681 | Stephen W Merriam | Ophthalmology | 5792 Widewaters Pkwy, Syracuse, NY 13214-1847 | 2006-03-02 |
| 1669456349 | Stephen G Spitzer | Ophthalmology | 5792 Widewaters Pkwy Ste 3, Syracuse, NY 13214-1847 | 2005-12-06 |
| 1528059995 | George O Temnycky | Ophthalmology | 1304 Buckley Rd, Suite 205, Syracuse, NY 13212-4311 | 2005-11-03 |
| 1295723534 | Syracuse Eye Physicians,llp | Ophthalmology | 716 James St, Ste 108, Syracuse, NY 13203-2087 | 2005-10-11 |
| 1871588210 | George Robert Hampton | Ophthalmology | 3107 E Genesee St, Syracuse, NY 13224-1646 | 2005-09-13 |
| 1033112487 | Charles Teitelbaum | Ophthalmology | 5792 Widewaters Pkwy Ste 101, Syracuse, NY 13214-1847 | 2005-05-31 |
| 1821091315 | Kenneth H Spitzer | Ophthalmology | 1101 Erie Blvd E, Ste 100, Syracuse, NY 13210-1144 | 2005-05-27 |
| Find all providers in SYRACUSE | ||||
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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.