Individual provider Active NPI

H Suzanne Moon, PHD

  • Health Service Psychologist
  • Weymouth, MA
National Provider Identifier
1104906114
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
7771 Issued in MA
Practice address
169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101
Phone
(781) 682-1060
Fax
(781) 682-1061
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7771 MA
Health Service Psychologist 103TH0100X 7771 MA Primary

Addresses

Primary practice location

169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101

Mailing address

169 Libbey Industrial Pkwy
2ND Floor
Weymouth, MA 02189-3101
Phone (781) 682-1060

Other identifiers 3

IdentifierTypeStateIssuer
W06212OtherMABCBS PROVIDER NUMBER
0502197MedicaidMA
A866565OtherMDVALUE OPTIONS PROVIDER NU

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051003000740 MA Practitioner - Clinical Psychologist 0446285068 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
7771MAMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
H Suzanne Moon, PHD, PC Clinical CurrentSince Jan 3, 2011 Accepting new patients
Pinnacle Health Management, LLP PastSince Apr 15, 1998 Accepting new patients
Golden Insight Inc PastSince Apr 25, 2021 Accepting new patients
Neurobehavioral Associates III, Inc Clinical PastSince May 25, 1999 Accepting new patients

Locations

210 Winter St
Ste 105
Weymouth, MA 02188
Phone (617) 312-7818

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1104906114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 LIBBEY INDUSTRIAL PKWY",
            "address_2": "2ND FLOOR",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021893101",
            "telephone_number": "781-682-1060",
            "fax_number": "781-682-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOON",
        "first_name": "H",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7771",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "7771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "W06212",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0502197",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER NU",
            "identifier": "A866565",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.