Individual provider Active NPI

Deann Moore, M.D.

  • Pediatrics Physician
  • Livingston, NJ
National Provider Identifier
1982048690
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA09878400 Issued in NJ
Practice address
571 W Mount Pleasant Ave
Livingston, NJ 07039-1607
Phone
(973) 992-4767
NPI assigned
Apr 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA09878400 NJ Primary

Addresses

Primary practice location

571 W Mount Pleasant Ave
Livingston, NJ 07039-1607

Mailing address

390 Memorial Pkwy
Bloomfield, NJ 07003-4263
Phone (202) 714-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20161003000467 NY Practitioner - Pediatric Medicine 6002103249 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25MA09878400NJMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center Pediatrics CurrentSince Aug 11, 2016 Accepting new patients
Montefiore Medical Center CurrentSince Aug 11, 2016 Accepting new patients
PM Pediatrics PC Pediatrics Past Accepting new patients
Denville Pediatrics Associates PA Pediatrics Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
PM Pediatrics of Bayside PLLC Past Accepting new patients
PM Pediatrics of Mamaroneck Past Accepting new patients
University Physician Associates of New Jersey Inc Past Accepting new patients
BCD Health Partners Pediatrics Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

2532 Grand Concourse
Bronx, NY 10458
Phone (718) 960-1500

Interoperability endpoints

  • Direct secure messaging: dea@bcd.pcc-direct.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1982048690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MEMORIAL PKWY",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034263",
            "telephone_number": "202-714-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 W MOUNT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391607",
            "telephone_number": "973-992-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-24",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09878400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.