Individual provider Active NPI

Jessica Moore, PH.D.

  • Clinical Psychologist
  • Rochester, NY
National Provider Identifier
1245467174
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020367 Issued in NY
Practice address
300 Crittenden Blvd
Dept of Psychiatry
Rochester, NY 14642-0001
Phone
(585) 922-4886
Fax
(585) 276-2292
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20367 NY
Clinical Psychologist 103TC0700X 020367 NY Primary

Addresses

Primary practice location

300 Crittenden Blvd
Dept of Psychiatry
Rochester, NY 14642-0001

Mailing address

300 Crittenden Blvd
Dept of Psychiatry
Rochester, NY 14642-0001
Phone (585) 922-4886

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jmoore48169@direct.urmc.rochester.edu Direct
Direct Messaging Address jmoore48169@direct.urmc.rochester.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151102000233 NY Practitioner - Clinical Psychologist 8628388709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of RochesterGroup PAC ID 5799699088, 960 clinicians

Practice addresses (Care Compare)

601 Elmwood Ave
Rochester, NY 14642-0001

601 Elmwood Ave
Rochester, NY 14642-0002
Phone (585) 275-2100

738 Library Rd
Rochester, NY 14642-0001
Phone (585) 275-2638

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20367NYMDPsychologist
020367NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Rochester Department of Psychiatry Clinical Group Psychologist CurrentSince Sep 1, 2015 Accepting new patients
Rochester General Hospital CurrentSince Sep 1, 2015 Accepting new patients
Cardiac Surgery of the University of Rochester Current Accepting new patients
University of Rochester CurrentSince Sep 1, 2015 Accepting new patients
University of Rochester CurrentSince Sep 1, 2015 Accepting new patients
Rochester General Hospital CurrentSince Sep 1, 2015 Accepting new patients
University of Rochester Current Accepting new patients
Acute Care Trauma of the University of Rochester Current Accepting new patients

Locations

1425 Portland Ave
Rochester, NY 14621
Phone (585) 922-3122

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

300 Crittenden Blvd
Rochester, NY 14642
Phone (585) 275-3569

100 Kings Hwy S
Rochester, NY 14617
Phone (585) 922-0553

Organizations & group practices 8

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": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1245467174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "address_2": "DEPT OF PSYCHIATRY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-922-4886",
            "fax_number": "585-276-2292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CRITTENDEN BLVD",
            "address_2": "DEPT OF PSYCHIATRY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146420001",
            "telephone_number": "585-922-4886",
            "fax_number": "585-276-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JESSICA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "20367",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoore48169@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmoore48169@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.