Individual provider Active NPI

Shaheda Nia Moore, NP

  • Critical Care Medicine Nurse Practitioner
  • Yonkers, NY
National Provider Identifier
1669036323
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
432227 Issued in NY
Practice address
340 S Broadway
Yonkers, NY 10705-2049
Phone
(914) 968-5125
Fax
(914) 968-5123
NPI assigned
Apr 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 432227 NY Primary

Addresses

Primary practice location

340 S Broadway
Yonkers, NY 10705-2049

Mailing address

746 Mamaroneck Ave Apt 1410
Mamaroneck, NY 10543-1990
Phone (917) 371-3334

Other practice location 1

174 Grand St
White Plains, NY 10601-4803
Phone (914) 328-6080

Other practice location 2

1 Bridge St
Ardsley, NY 10502-2136
Phone (914) 639-8787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220527000528 NY Practitioner - Nurse Practitioner 6901131127 Reassigns benefits to 4 organizations
I20230315000014 NJ Practitioner - Nurse Practitioner 6901131127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10 Maple St
Port Washington, NY 11050-2905

200 Broadway
Brooklyn, NY 11211-6130

255 Executive Dr
210B
Plainview, NY 11803-1711

3438 Bell Blvd
Suite 301
Bayside, NY 11361-1739

44 Nassau Dr
Great Neck, NY 11021-1441

445 Park Ave
Brooklyn, NY 11205-2735

9 Meron Dr
Unit 14
Monroe, NY 10950-8436

Hospital & facility affiliations

  • White Plains Hospital Center Hospital, White Plains, NY, CCN 330304

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Care Medical Group, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Rd Medical Professional Services PC CurrentSince Apr 3, 2024 Accepting new patients
Infinite Medical PC CurrentSince Feb 1, 2024 Accepting new patients
Parcare Community Health Network Inc CurrentSince Aug 8, 2023 Accepting new patients
Parcare Community Health Network Inc CurrentSince Aug 8, 2023 Accepting new patients
Nys Medical Associate PLLC CurrentSince Dec 16, 2023 Accepting new patients
Doctors United, Inc PastSince Oct 1, 1997 Accepting new patients
R.G. Medical, PC Past Accepting new patients
Doral Pharmacy LLC Past Accepting new patients

Locations

101 Walnut St
Neptune City, NJ 07753
Phone (732) 774-2336

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

250 Skillman St
Ste 202
Brooklyn, NY 11205

141 Dosoris Ln
Glen Cove, NY 11542
Phone (516) 676-1100

300 Community Dr
Plandome, NY 11030

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

6111 Queens Blvd
Woodside, NY 11377
Phone (718) 205-0287

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1669036323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 MAMARONECK AVE APT 1410",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105431990",
            "telephone_number": "917-371-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107052049",
            "telephone_number": "914-968-5125",
            "fax_number": "914-968-5123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "174 Grand St",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106014803",
            "country_code": "US",
            "telephone_number": "914-328-6080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Bridge St",
            "address_purpose": "LOCATION",
            "city": "Ardsley",
            "state": "NY",
            "postal_code": "105022136",
            "country_code": "US",
            "telephone_number": "914-639-8787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHAHEDA",
        "middle_name": "NIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "NY",
            "license": "432227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yonkers, NY

Sources for this page

Verify at the official NPI Registry.