Madelyn Moore, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-25-79343 Issued in FL

Practice address

185 Landrum LN
Ponte Vedra Beach, FL 32082-3824

Phone

(904) 509-8170

NPI assigned

Dec 20, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Nocal Behavioral Services LLC

  • Behavior Analyst
  • Ponte Vedra, FL
  • NPI 1184084782
  NPD (past)

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1912667866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 LANDRUM LN",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320823824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 LANDRUM LN",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823824",
            "telephone_number": "904-509-8170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MADELYN",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-25-79343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miteshkumar Patel M.D., Core Continuity of Care Inc.
• Andrea Louise Mixer, PTA
• Susan Rost Monahan, OD
• Samantha Jo Monson, M.S., CCC-SLP
• Raphael Christa Montgomery, PT
• Sarah Morgan
• Shannon Morgan, FNP-BC
• Elizabeth Moscarillo, LMHC
• Lewis Jay Moskowitz, LMHC
• Motor Mouth Speech and Feeding Therapy LLC

• Behavior Analyst in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.