Individual provider Active NPI

Kimberly Moore, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fishkill, NY
National Provider Identifier
1407371644
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
342112 Issued in NY
Practice address
30 Maurerbrook Dr
Fishkill, NY 12524-1115
Phone
(845) 335-7734
NPI assigned
Aug 9, 2017
Last updated
Aug 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 342112 NY Primary

Addresses

Primary practice location

30 Maurerbrook Dr
Fishkill, NY 12524-1115

Mailing address

30 Maurerbrook Dr
Fishkill, NY 12524-1115
Phone (845) 590-8611

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106000830 NY Practitioner - Nurse Practitioner 0345506416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

21 Reade PL
Suite 3100a
Poughkeepsie, NY 12601-3944
Phone (845) 214-1900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.38 of 100Reported as group
Quality
63.01
Promoting interoperability
98
Improvement activities
40
Cost
72.3

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvance Health Medical Practice PC CurrentSince Jan 27, 2018 Accepting new patients

Locations

1351 Route 55
Ste 200
Lagrangeville, NY 12540
Phone (845) 475-9622

21 Reade Pl
Ste 2400
Poughkeepsie, NY 12601
Phone (845) 214-1300

21 Reade Pl
Ste 3100
Poughkeepsie, NY 12601
Phone (845) 214-1800

21 Reade Pl
Ste 3100A
Poughkeepsie, NY 12601
Phone (845) 214-1900

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

45 Reade Pl
Fl 2
Poughkeepsie, NY 12601
Phone (845) 483-6001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1502236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1407371644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAURERBROOK DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241115",
            "telephone_number": "845-590-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAURERBROOK DR",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125241115",
            "telephone_number": "845-335-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KIMBERLY",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-09",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "342112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishkill, NY

Sources for this page

Verify at the official NPI Registry.