Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Douglas R Moore, DO

Individual provider Cardiovascular Disease Physician · NPI 1194729053

Dr. Douglas R Moore, DO is a Cardiac Electrophysiology in Roseville, Michigan. Qualified in 1996, 30 years ago. Practices with Mercy Health Westshore Cardiology Services, a 36-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan and Virginia.

Years since qualifying
30
Licensed in
MI, VA
In the registry since
2005
Specialties on file
3
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

25195 Kelly Rd Ste A
Roseville, MI 48066-4909
Phone: (586) 775-4594
Fax: (586) 775-4506
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 310 Lafayette Ave Se Ste 300, Grand Rapids, MI 49503-4693 — (616) 685-3450
  • 1223 Mercy Dr, Muskegon, MI 49444-1829 — (231) 672-3500

Specialties & licences

Clinical Cardiac Electrophysiology Physician (primary) Taxonomy 207RC0001X · Licence 5101013212 (MI)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence 0102202087 (VA)
Clinical Cardiac Electrophysiology Physician Taxonomy 207RC0001X · Licence 0102202087 (VA)

Record details

NPI number1194729053
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESOctober 11, 2024
Certification dateOctober 11, 2024
Mailing address25195 Kelly Rd Ste A, Roseville, MI 48066-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCARDIAC ELECTROPHYSIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Mercy Health Westshore Cardiology Services — 36 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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