Individual provider Active NPI

Judith Clair Moore, CPNP

  • Registered Nurse
  • Newark, NY
National Provider Identifier
1386680783
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
416572 Issued in NY
Practice address
131 Drumlin CT
Newark, NY 14513-1863
Phone
(315) 332-7400
NPI assigned
Jun 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X F3807831 NY
Registered Nurse 163W00000X 416572 NY Primary

Addresses

Primary practice location

131 Drumlin CT
Newark, NY 14513-1863

Mailing address

131 Drumlin CT
Newark, NY 14513-1863
Phone (315) 332-7400

Other identifiers 3

IdentifierTypeStateIssuer
109424DLOtherPFC
02258175OtherMED
P019380783OtherBC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
416572NYMDRegistered Nurse
F3807831NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
David H. Breen MD PLLC Pediatrics PastSince Mar 1, 2005 Accepting new patients

Organizations & group practices 1

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": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1386680783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DRUMLIN CT",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131863",
            "telephone_number": "315-332-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 DRUMLIN CT",
            "city": "NEWARK",
            "state": "NY",
            "postal_code": "145131863",
            "telephone_number": "315-332-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUDITH",
        "middle_name": "CLAIR",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "F3807831",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "416572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PFC",
            "identifier": "109424DL",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED",
            "identifier": "02258175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "P019380783",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.