SHANNEN MOORE
NPI 1083092977
Nurse Practitioner - Pediatrics in Boston, MA
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
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
2Medicare enrollment records show Shannen Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Chappaqua, NY 10514
- Reassigned Medicare billing, New York enrollment
- 1,406 clinicians in this Medicare group
New York, NY 10029
- Reassigned Medicare billing, New York enrollment
- 245 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
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, NYMount Sinai South Nassau
Acute Care Hospitals · Oceanside, NYPhysician 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.
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.
Which organizations bill Medicare for Shannen Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shannen Moore reassigns Medicare benefits to 2 organizations: North Shore - Lij Anesthesiology, PC (Chappaqua, NY) and Icahn School Of Medicine At Mount Sinai (New York, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannen Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Shannen Moore affiliated with any hospitals?
According to CMS data, Shannen Moore is affiliated with Long Island Jewish Medical Center and Mount Sinai South Nassau.
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 9 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.
# Shannen Moore · NPI 1083092977
Pediatrics physician in Boston, Massachusetts. Individual provider, active in the CMS NPPES registry since May 11, 2015.
## Identity
- **NPI:** 1083092977 (Entity type: Individual)
- **Enumerated:** May 11, 2015
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 383018 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 8 WATERMAN RD, Boston, MA 02131-2218
- **Phone:** (857) 345-0003
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): North Shore - Lij Anesthesiology, PC (NPI 1417401266, Chappaqua, NY); Icahn School Of Medicine At Mount Sinai (NPI 1447008446, New York, NY) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2025
## Record status
- **NPPES last updated:** January 27, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1083092977) · Data from the CMS NPPES public registry.