Mark Moore, PHD

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

PS015627 Issued in PA

Practice address

230 W Washington SQ
2ND Floor
Philadelphia, PA 19106-3500

Phone

(215) 829-6088

Fax

(215) 829-6104

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Moore Psychotherapy Care LLC

  • Clinical Psychologist
  • Philadelphia, PA
  • NPI 1265856447
  Medicare reassignment NPD Authorized official
• Pennsylvania Oncology Hematology Associates PC

  • Non-Pharmacy Dispensing Site
  • Philadelphia, PA
  • NPI 1154378867
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669690905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "215-829-6088",
            "fax_number": "215-829-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W WASHINGTON SQ",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191063500",
            "telephone_number": "215-829-6088",
            "fax_number": "215-829-6104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "PA",
            "license": "PS015627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Moore, ATR
• Leslie Carol Moore, CRNP FNP
• Lisa Joy Moore, MSS
• Mallory Marshall Moore, LSW
• Margaret Marie Moore, M.D.
• Megan Moore, CRNA
• Megan Kathleen Moore, CRNP
• Melissa A Moore, CRNP
• Michael M. Moore, M.D.
• Michal Desiree Moore

• Prescribing (Medical) Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Prescribing (Medical) Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.