DR. CHARLES N MOORE JR. D.MIN.
NPI 1104988500
Psychologist - Family in Essex, MA
About Dr. Charles N Moore Jr. D.min. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. CHARLES N MOORE JR. D.MIN. (NPI 1104988500) is an individual family provider in Essex, Massachusetts, licensed in Massachusetts (2097) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1974).
NPPES Registry Identity
Specialties & Licenses 4
Accepted Insurance
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
Dr. Charles N Moore Jr. D.min. 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 Charles Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Stoneham, MA 02180
- Reassigned Medicare billing, Massachusetts enrollment
- 66 clinicians in this Medicare group
Needham, MA 02492
- Reassigned Medicare billing, Massachusetts enrollment
- 240 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.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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 Charles Moore's NPI number?
The NPI number for Charles Moore is 1104988500. It was assigned to this individual provider in the NPPES registry on December 14, 2006.
Where is Charles Moore located?
Charles Moore practices at 23 Spring St, Essex, MA 01929. The listed phone number is (978) 884-8641.
What is Charles Moore's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Family, with taxonomy code 103TF0000X.
Is Charles Moore enrolled in Medicare?
Yes. Charles 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 Charles Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Charles Moore reassigns Medicare benefits to 2 organizations: Supportive Behavioral Care Of Mass LLC (Stoneham, MA) and Supportive Behavioral Care Of Ma LLC (Needham, MA). 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 Charles Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Charles Moore accept?
Health plans from Harvard Pilgrim Health Care list Charles Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Charles Moore was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Dr. Charles N Moore Jr., D.MIN. · NPI 1104988500
Family provider in Essex, Massachusetts. Individual provider, active in the CMS NPPES registry since December 14, 2006.
## Identity
- **NPI:** 1104988500 (Entity type: Individual)
- **Enumerated:** December 14, 2006
- **Primary specialty:** Psychologist - Family · taxonomy 103TF0000X
- **State license:** 2097 (Massachusetts)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 23 SPRING ST, Essex, MA 01929-1311
- **Phone:** (978) 884-8641
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Supportive Behavioral Care Of Mass LLC (NPI 1932914223, Stoneham, MA); Supportive Behavioral Care Of Ma LLC (NPI 1780115519, Needham, MA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1974
## Record status
- **NPPES last updated:** September 11, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1104988500) · Data from the CMS NPPES public registry.