Physician Compare National (NPI:1447409248)

HEALTHCARE PROVIDER: STEVEN MICHAEL MOORE DC, ND

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

Individual Professional Information
NPI	1447409248
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1153480926
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20181101002745
	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	STEVEN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SANDA HEALTHCARE
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9234407412
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	20 TECHNOLOGY DR
	Group Practice or individual's line 1 address
Line 2 Street Address	UNIT 1
	Group Practice or individual's line 2 address
City	BRATTLEBORO
	Group Practice or individual's city
State	VT
	Group Practice or individual's state
Zip Code	053019181
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7192376643
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	470011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BRATTLEBORO MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	300019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHESHIRE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	471300
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GRACE COTTAGE HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y