Oliver Moore, DNP, APN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

26NJ00872800 Issued in NJ

Practice address

550 Broad St Ste 606
Newark, NJ 07102-4537

Phone

(201) 822-1161

Fax

(877) 485-8918

NPI assigned

Oct 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Nurse Practitioner

Education

Rutgers New Jersey Medical School, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

JLS Medical PCGroup PAC ID 7719342005, 53 clinicians

Center for Family Guidance PCGroup PAC ID 2860396454, 164 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: oliver.moore.p1@direct.cfg.nextgenshare.com

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.

• Center for Family Guidance, PC

  • Geriatric Psychiatry Physician
  • Marlton, NJ
  • NPI 1508803388

  Single Specialty

  Medicare reassignment Care Compare group NPD
• JLS Medical PC

  • Psychiatry Physician
  • Newark, NJ
  • NPI 1164007043

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Moorehalth

  • Psychiatric/Mental Health Nurse Practitioner
  • Marlton, NJ
  • NPI 1366172843

  Single Specialty

  NPD Authorized official
• Aspen Hills Healthcare Center LLC

  • Psychiatric Hospital
  • Pemberton, NJ
  • NPI 1396093613
  NPD (past)
• Bancroft, a New Jersey Nonprofit Corporation

  • Rehabilitation Clinic/Center
  • Cherry Hill, NJ
  • NPI 1720121106

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1770068942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 MARLTON PIKE W # 407",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532075",
            "telephone_number": "323-853-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 BROAD ST STE 606",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071024537",
            "telephone_number": "201-822-1161",
            "fax_number": "877-485-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Jackson Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NJ",
            "postal_code": "080559231",
            "country_code": "US",
            "telephone_number": "323-853-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "OLIVER",
        "name_prefix": "Dr.",
        "credential": "DNP, APN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-03",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ00872800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0813451",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaly Montilus, APN
• Kyoung Moon, MD
• Woo Moon, MD
• Athanasia Moore
• Marlena Shantal Moore, DPM
• Ross Edward Moore, M.D.
• Sherone Moore, RBT-16-14008
• Spencer Conrad Moore
• Taiwo Damilola Moore
• Ehsan Moosavi

• Psychiatric/Mental Health Nurse Practitioner in Newark, NJ
• Providers in Newark, NJ by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.