SHANNEN MOORE
NPI 1083092977
Nurse Practitioner - Pediatrics in Boston, MA

Active since May 11, 2015Accepts Medicare Assignment
8 WATERMAN RD, BOSTON, MA 02131(857) 345-0003 Get Directions Write a Review

NPPES record last updated: January 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 27, 2026, Feb 4, 2020 (2 updates tracked since 2020).

About Shannen Moore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNEN MOORE (NPI 1083092977) is an individual pediatrics provider in Boston, Massachusetts, licensed in New York (383018) and active in the NPI registry since May 2015. She is affiliated with Long Island Jewish Medical Center and is a graduate of Other (2025).

NPPES Registry Identity

NPI1083092977
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameSHANNEN MOORE
Location Address8 WATERMAN RDBoston, MA 02131-2218
Mailing Address10 Monroe Blvd Apt 6fLong Beach, NY 11561-4355 · (857) 345-0003
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateMay 11, 2015
Last NPPES UpdateJanuary 27, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 27, 2026
NPI 1083092977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License Licensed in NY · 383018
Also ListedRegistered Nurse · PediatricsTaxonomy 163WP0200X · License 701502 (NY)
Also ListedNurse Anesthetist, Certified RegisteredTaxonomy 367500000X · License 701502 (NY)
8 WATERMAN RD, Boston, MA 02131

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Shannen Moore is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567940950
PECOS Enrollment IDI20260128000843

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Long Island Jewish Medical Center

Acute Care Hospitals · New Hyde Park, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330195
Location270 - 05 76th AvenueNew Hyde Park, NY 11040 · Nassau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02131 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannen Moore's NPI number?

The NPI number for Shannen Moore is 1083092977. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Shannen Moore located?

Shannen Moore practices at 8 Waterman Rd, Boston, MA 02131. The listed phone number is (857) 345-0003.

What is Shannen Moore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Shannen Moore enrolled in Medicare?

Yes. Shannen Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Shannen Moore affiliated with any hospitals?

According to CMS data, Shannen Moore is affiliated with Long Island Jewish Medical Center.

When was this NPI record last updated?

The NPPES record for Shannen Moore was last updated on January 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.