Gloria L Moore, FNP is a medicare enrolled "Nurse Practitioner - Family" physician in Port Huron, Michigan. Her current practice location is
2601 Electric Ave, Port Huron, Michigan. You can reach out to her office (for appointments etc.) via phone at
(810) 216-1500.
Gloria L Moore is licensed to practice in Michigan (license number 4704301246NSA220SA) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073235859.
Physician's Profile
Full Name | Gloria L Moore |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 2601 Electric Ave, Port Huron, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1073235859
- Provider Enumeration Date: 09/19/2022
- Last Update Date: 01/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 4284089574
- Enrollment ID: I20231005003016
Medical Identifiers
Medical identifiers for Gloria L Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073235859 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RS0012X | Internal Medicine - Sleep Medicine | 4704301246 (Michigan) | Secondary |
163WW0000X | Registered Nurse - Wound Care | 4704263386 (Michigan) | Secondary |
163WX1500X | Registered Nurse - Ostomy Care | 4704263386 (Michigan) | Secondary |
225200000X | Physical Therapy Assistant | (* (Not Available)) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 4704263386 (Michigan) | Secondary |
363LF0000X | Nurse Practitioner - Family | 4704301246NSA220SA (Michigan) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Gloria L Moore allows following entities to bill medicare on her behalf.
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20210405000855 |
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Entity Name | Vinculum Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306538079 PECOS PAC ID: 1557716842 Enrollment ID: O20231005002925 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gloria L Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Gloria L Moore, FNP 5316 Lakeshore Rd, Fort Gratiot, MI 48059-3118 Ph: (810) 357-8792 | Gloria L Moore, FNP 2601 Electric Ave, Port Huron, MI 48060-6587 Ph: (810) 216-1500 |
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