Individual provider Active NPI

Jennifer Moore, M.D.

  • Gynecology Physician
  • Vero Beach, FL
National Provider Identifier
1891701355
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME90718 Issued in FL
Practice address
787 37TH St Ste 140
Vero Beach, FL 32960-7305
Phone
(772) 257-8224
Fax
(772) 252-3245
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME90718 FL Primary

Addresses

Primary practice location

787 37TH St Ste 140
Vero Beach, FL 32960-7305

Mailing address

1555 Indian River Blvd Ste B210
Vero Beach, FL 32960-7113
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
ME90718OtherFLFL MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116000199 FL Practitioner - Obstetrics/Gynecology 3577547306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of South Florida College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Treasure Coast Community Health IncGroup PAC ID 4082625827, 28 clinicians

Practice addresses (Care Compare)

12196 County Rd
Suite 512
Fellsmere, FL 32948-5463
Phone (772) 257-8224

1555 US Hwy 1
Vero Beach, FL 32960-4727
Phone (772) 257-8224

787 37TH St
Suite 140
Vero Beach, FL 32960-7305
Phone (772) 257-8224

Hospital & facility affiliations

  • Cleveland Clinic Indian River Hospital Hospital, Vero Beach, FL, CCN 100105

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.

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1891701355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDIAN RIVER BLVD STE B210",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607113",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 37TH ST STE 140",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607305",
            "telephone_number": "772-257-8224",
            "fax_number": "772-252-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME90718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICAL LICENSE",
            "identifier": "ME90718",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

Verify at the official NPI Registry.