Physician Compare National (NPI:1144229246)

HEALTHCARE PROVIDER: DR. PATRICIA A MOORE

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1144229246
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002930419
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100907000806
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOORE
	Individual professional last name
Provider First Name	PATRICIA
	Individual professional first name
Provider Middle Name	ANN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	52303 EMMONS RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A7
	Group Practice or individual's line 2 address
City	SOUTH BEND
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	466374293
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5742775390
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y