Individual provider Active NPI

John Moyer, REGISTED NURSE

  • Psychiatric/Mental Health Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1548072721
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
407741 Issued in NY
Practice address
1 South Ave # 11530
Garden City, NY 11530-4299
Phone
(917) 268-1189
NPI assigned
Jan 23, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ15459700 NJ
Registered Nurse 163W00000X 845333 NY
Registered Nurse 163W00000X 26NR24761000 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 407741 NY Primary

Addresses

Primary practice location

1 South Ave # 11530
Garden City, NY 11530-4299

Mailing address

1 South Ave # 11530
Garden City, NY 11530-4299
Phone (917) 268-1189

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
I20260520000653 NY Practitioner - Nurse Practitioner 3173092004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

28 Arrow LN
Hicksville, NY 11801-4414

618 Ave Jose Efron
Unit 649
Dorado, PR 00646

80 5TH Ave
Suite 903 10
New York, NY 10011-8020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NR24761000NJMDRegistered Nurse
845333NYMDRegistered Nurse
26NJ15459700NJMDPsychiatric/Mental Health Nurse Practitioner
407741NYMDPsychiatric/Mental Health Nurse Practitioner

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": "1737590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1548072721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SOUTH AVE # 11530",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304299",
            "telephone_number": "917-268-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SOUTH AVE # 11530",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115304299",
            "telephone_number": "917-268-1189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "JOHN",
        "credential": "REGISTED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-23",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ15459700",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "845333",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR24761000",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "407741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.