Individual provider Active NPI

Angela P. Moore

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1386056018
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2020 Commerce Dr
Melbourne, FL 32904-2335
Phone
(321) 952-6000
NPI assigned
May 29, 2014
Last updated
Aug 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2020 Commerce Dr
Melbourne, FL 32904-2335

Mailing address

400 East Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5200

Other practice location 1

2222 Colonial Rd Ste 100
Fort Pierce, FL 34950-5309
Phone (772) 489-4726

Other practice location 2

3906 Jupiter Blvd SE
Palm Bay, FL 32909-3861
Phone (321) 505-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240411000651 FL Practitioner - Mental Health Counselor 3577901453 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circles of Care IncGroup PAC ID 8729069380, 26 clinicians

Practice addresses (Care Compare)

2020 Commerce Dr
West Melbourne, FL 32904-2335
Phone (321) 952-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Circles of Care, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Circles of Care, Inc. Mental Health CurrentSince Mar 1, 2024 Accepting new patients

Locations

400 Sheridan Rd
Melbourne, FL 32901
Phone (321) 722-5273

2020 Commerce Dr
West Melbourne, FL 32904
Phone (321) 952-6000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1386056018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 EAST SHERIDAN RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 COMMERCE DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329042335",
            "telephone_number": "321-952-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Colonial Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349505309",
            "country_code": "US",
            "telephone_number": "772-489-4726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3906 Jupiter Blvd SE",
            "address_purpose": "LOCATION",
            "city": "Palm Bay",
            "state": "FL",
            "postal_code": "329093861",
            "country_code": "US",
            "telephone_number": "321-505-3370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "middle_name": "P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.