Wietske Moore
SAN MIGUEL CLINIC CORP


Address: 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Phone: 5054252662

Wietske Moore (NPI# 1235291394, PAC ID# 9638073760) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1235291394
PAC ID by PECOS 9638073760
Professional Enrollment ID I20031120000990
Full Name Wietske Moore
Organization Legal Name SAN MIGUEL CLINIC CORP
Address 2515 Ridge Runner Rd
Las Vegas
NM 87701-4972
Phone Number 5054252662
Gender F
Credential NP
Graduation Year 2001
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 1254226079
Number of Group Practice Members 8
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
320003 ALTA VISTA REGIONAL HOSPITAL
320002 CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER

Other Locations

Address Phone Organization
2515 Ridge Runner Rd, Las Vegas, NM 87701-4972 5054252662 SAN MIGUEL CLINIC CORP

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %
MIPS_EC_047_overall Care Plan 19%
MIPS_EC_333_overall Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse) (100%: worst, 0% best) 0%

Organization Information

Organization Legal Name SAN MIGUEL CLINIC CORP
Physicians 8

Physicians with the same organization

Name Specialty Organization Address
Nancy J Wright Pediatric Medicine San Miguel Clinic Corp 501 7th St, Las Vegas, NM 87701-3993
Chenthuran Deivaraju Orthopedic Surgery San Miguel Clinic Corp 104 Legion Dr, Suite 4, Las Vegas, NM 87701-4804
Raymond F Ortiz Internal Medicine San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Franklin Miller Pulmonary Disease San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Tracy Wilkerson Obstetrics/gynecology San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898
Morgan E Schopen Certified Nurse Midwife San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898
Carol A Kiesling Obstetrics/gynecology San Miguel Clinic Corp 108 Legion Dr, Suite A, Las Vegas, NM 87701-4898

Office Location

Street Address 2515 RIDGE RUNNER RD
City LAS VEGAS
State NM
Zip 87701-4972

Physicians in the same location

Name Specialty Organization Address
Raymond F Ortiz Internal Medicine San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972
Franklin Miller Pulmonary Disease San Miguel Clinic Corp 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972

Physicians in the same zip code

Name Specialty Organization Address
Jasmin U Breitung Internal Medicine 2213 Hot Springs Blvd, Las Vegas, NM 87701-3449
Bruce A Andersen Podiatry 109 Railroad Ave, Las Vegas, NM 87701-3853
Nancy J Wright Pediatric Medicine San Miguel Clinic Corp 501 7th St, Las Vegas, NM 87701-3993
Leigh A Trivino Physician Assistant El Centro Family Health 901 Baca Ave, Las Vegas, NM 87701-4000
Michael L Mcfall Physical Therapy 2810 Hot Springs Blvd, Suite A, Las Vegas, NM 87701-4119
G. Michael Lopez Internal Medicine 105 Mills Ave, Suite 300, Las Vegas, NM 87701-4169
Louise M La Plante Clinical Social Worker 3001 Hot Springs Blvd, Suite C, Las Vegas, NM 87701-4175
Matthew D Probst Physician Assistant El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Michael J Lee Physician Assistant El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Laura Robinson Nurse Practitioner El Centro Family Health 1235 8th St, Las Vegas, NM 87701-4219
Find all physicians in zip 87701

Competitor

Search similar physicians

City LAS VEGAS
Zip Code 87701
Specialty NURSE PRACTITIONER
City + Specialty LAS VEGAS + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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