Wietske Moore (NPI# 1235291394, PAC ID# 9638073760) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
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 |
Claim Control Number (CCN) | Legal Business Name |
---|---|
320003 | ALTA VISTA REGIONAL HOSPITAL |
320002 | CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
2515 Ridge Runner Rd, Las Vegas, NM 87701-4972 | 5054252662 | SAN MIGUEL CLINIC CORP |
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 Legal Name | SAN MIGUEL CLINIC CORP |
Physicians | 8 |
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 |
Street Address |
2515 RIDGE RUNNER RD |
City | LAS VEGAS |
State | NM |
Zip | 87701-4972 |
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 |
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 |
City | LAS VEGAS |
Zip Code | 87701 |
Specialty | NURSE PRACTITIONER |
City + Specialty | LAS VEGAS + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Wietske Moore.
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.