Individual provider Active NPI

Paula Jayne Moore, R.N.CNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Amherst, MA
National Provider Identifier
1528130457
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
142836 Issued in MA
Practice address
433 West St Ste 5
Amherst, MA 01002-2936
Phone
(413) 570-0746
Fax
(413) 256-6476
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 142836 MA Primary

Addresses

Primary practice location

433 West St Ste 5
Amherst, MA 01002-2936

Mailing address

785 Wendell Rd
Shutesbury, MA 01072-9733
Phone (413) 570-0746

Other identifiers 1

IdentifierTypeStateIssuer
1305263MedicaidMA

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 Nurse Specialist

State licenses

LicenseStateTypeSpecialty
142836MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Inc PastSince Feb 2, 2025 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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1528130457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 WENDELL RD",
            "city": "SHUTESBURY",
            "state": "MA",
            "postal_code": "010729733",
            "telephone_number": "413-570-0746",
            "fax_number": "413-256-6476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 WEST ST STE 5",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010022936",
            "telephone_number": "413-570-0746",
            "fax_number": "413-256-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PAULA",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "R.N.CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "142836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305263",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; 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.