Individual provider Active NPI

Justin R Moore, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Melbourne, FL
National Provider Identifier
1235339870
Registry record updated Jun 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
ME155579 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901-3224
Phone
(321) 434-4225
NPI assigned
Jul 23, 2007
Last updated
Jun 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35.127204 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X ME155579 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901-3224

Mailing address

3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 434-4225

Other practice location 1

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4024

Other practice location 2

100 Medical Center Dr
Springfield, OH 45504-2687
Phone (937) 523-4147

Other practice location 3

12920 US Highway 1 Ste A
Sebastian, FL 32958-3772
Phone (772) 388-8322

Other identifiers 3

IdentifierTypeStateIssuer
122863800MedicaidFL
0094481MedicaidOH
VI326OtherFLMEDICARE HF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, ND, VA, SC, IL, FL6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20160512000103 OH Practitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 5890955041 Reassigns benefits to 6 organizations
I20210212001881 ND Practitioner - Critical Care (Intensivists) 5890955041 Reassigns benefits to 1 organization
I20210526000318 VA Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5890955041 Reassigns benefits to 1 organization
I20210607000286 SC Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5890955041 Reassigns benefits to 2 organizations
I20230602002027 IL Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 5890955041 Reassigns benefits to 1 organization
I20240701003832 FL Practitioner - Critical Care (Intensivists) 5890955041 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health First Medical Group, LLCGroup PAC ID 7416100672, 701 clinicians

Practice addresses (Care Compare)

1350 Hickory St
Melbourne, FL 32901-3224
Phone (321) 434-1401

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

699 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3562

8745 N Wickham Rd
Melbourne, FL 32940-5997
Phone (321) 434-5162

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME155579FLMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Alexius Medical Center CurrentSince Jan 2, 2021 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Feb 27, 2023 Accepting new patients
Health First Medical Group, LLC Critical Care Medicine CurrentSince Jul 20, 2025 Accepting new patients
St. Alexius Medical Center CurrentSince Jan 2, 2021 Accepting new patients
RMH Medical Group LLC CurrentSince May 17, 2021 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Promedica Central Physicians CurrentSince Nov 2, 2020 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Feb 6, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Jun 14, 2024 Accepting new patients
Trihealth G LLC CurrentSince Sep 10, 2021 Accepting new patients
Orlando Health Medical Group Inc Critical Care Medicine CurrentSince Mar 31, 2025 Accepting new patients
Health First Medical Group, LLC CurrentSince Jul 20, 2025 Accepting new patients
Inpatient Medical Services, Inc. CurrentSince Oct 1, 2018 Accepting new patients
Steward Medical Group, Inc. CurrentSince Jun 14, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince May 14, 2021 Accepting new patients
4M Hospitalist Services, LLC CurrentSince Jan 1, 2021 Accepting new patients
Prisma Health Medical Group-Midlands Current Accepting new patients
RMH Medical Group LLC CurrentSince May 17, 2021 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Mar 31, 2025 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Critical Care Medicine CurrentSince Feb 6, 2023 Accepting new patients
Promedica Central Physicians CurrentSince Nov 2, 2020 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince May 14, 2021 Accepting new patients
Trihealth H LLC Critical Care Medicine CurrentSince Sep 10, 2021 Accepting new patients
Usacs Critical Care Medicine Services of Ohio, LLC Critical Care Medicine CurrentSince Sep 10, 2024 Accepting new patients
Trihealth G, LLC CurrentSince Sep 10, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Triven Health PastSince Mar 24, 2016 Accepting new patients
Meritra Physicians LLC Past Accepting new patients
Camden Clark Memorial Hospital Corporation Past Accepting new patients
Stewart and Stewart a Medical Corporation Past Accepting new patients

Locations (25 of 29)

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

3300 S Fiske Blvd
Rockledge, FL 32955
Phone (321) 434-1771

12920 US Highway 1
Ste A
Sebastian, FL 32958
Phone (772) 228-9808

3745 11th Cir
Ste 105
Vero Beach, FL 32960
Phone (772) 564-2485

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

815 Main St
Ste A1
Peoria, IL 61602

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

9 Galen St
Watertown, MA 02472
Phone (617) 562-5413

900 E Broadway Ave
Bismarck, ND 58501
Phone (701) 530-7300

375 Dixmyth Ave
Ste 3135
Cincinnati, OH 45220
Phone (513) 862-3452

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

2001 Anderson Ferry Rd
Cincinnati, OH 45238
Phone (513) 922-1200

3557 Embassy Pkwy
Fairlawn, OH 44333
Phone (330) 670-1005

1003 Bellefontaine Ave
Ste 150
Lima, OH 45804
Phone (419) 998-8207

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

14 Richland Medical Park Dr
Ste 320
Columbia, SC 29203
Phone (803) 434-1663

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: justin.moore.1@15594.direct.athenahealth.com
  • Direct secure messaging: jmoore81057@directmcleodehealth.org
  • Direct secure messaging: jmoore158366@epicdirect.hf.org

Organizations & group practices 30

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

View all 30

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748908800000",
    "number": "1235339870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 S FISKE BLVD",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329554306",
            "telephone_number": "321-434-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-4225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4024",
            "fax_number": "937-702-4035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OH",
            "postal_code": "455042687",
            "country_code": "US",
            "telephone_number": "937-523-4147",
            "fax_number": "937-523-4952",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12920 US Highway 1 Ste A",
            "address_purpose": "LOCATION",
            "city": "Sebastian",
            "state": "FL",
            "postal_code": "329583772",
            "country_code": "US",
            "telephone_number": "772-388-8322",
            "fax_number": "772-388-8323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-23",
        "last_updated": "2025-06-03",
        "certification_date": "2025-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35.127204",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "ME155579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122863800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094481",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE HF",
            "identifier": "VI326",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.