Dr Nicholas M Moore, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Atco, New Jersey. His current practice location is
7 Brookview Dr, Atco, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(856) 658-7653.
Dr Nicholas M Moore is licensed to practice in New Jersey (license number 35SI00631200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336795509.
Healthcare Provider's Profile
| Full Name | Dr Nicholas M Moore |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 7 Brookview Dr, Atco, New Jersey |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1336795509
- Provider Enumeration Date: 08/14/2019
- Last Update Date: 09/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355670472
- Enrollment ID: I20190913002205
Medical Identifiers
Medical identifiers for Dr Nicholas M Moore such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1336795509 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TC0700X | Psychologist - Clinical | PY10540 (Florida) | Secondary |
| 103TC0700X | Psychologist - Clinical | PS020137 (Pennsylvania) | Secondary |
| 103TC0700X | Psychologist - Clinical | 07284 (Maryland) | Secondary |
| 103TC0700X | Psychologist - Clinical | 35SI00631200 (New Jersey) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Nicholas M Moore allows following entities to bill medicare on his behalf.
| Entity Name | Mental Health Center Of Florida Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679021414
PECOS PAC ID: 9931485117
Enrollment ID: O20170425000910 |
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| Entity Name | Transformative Healthcare Solutions Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477114031
PECOS PAC ID: 8921337973
Enrollment ID: O20190917001257 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicholas M Moore is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Nicholas M Moore, PSYD
10000 Midlantic Dr Ste 101e,
Mount Laurel, NJ 08054-1504
Ph: (732) 982-2888 | Dr Nicholas M Moore, PSYD
7 Brookview Dr,
Atco, NJ 08004-2931
Ph: (856) 658-7653 |
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