JESSIE DAWN MOODIE-SHEPHERD NP
NPI 1578850376
Nurse Practitioner - Family in New York, NY
About Jessie Dawn Moodie-shepherd Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JESSIE DAWN MOODIE-SHEPHERD NP (NPI 1578850376) is an individual family provider in New York, New York, licensed in New York (F336664) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jessie Dawn Moodie-shepherd Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jessie Moodie-shepherd reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Spring Valley, NY 10977
- Reassigned Medicare billing, New York enrollment
- 64 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 10119 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10119
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 Jessie Moodie-shepherd's NPI number?
The NPI number for Jessie Moodie-shepherd is 1578850376. It was assigned to this individual provider in the NPPES registry on June 30, 2011.
Where is Jessie Moodie-shepherd located?
Jessie Moodie-shepherd practices at 1 Penn Plz 8th Floor, New York, NY 10119. The listed phone number is (646) 761-1725.
What is Jessie Moodie-shepherd's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jessie Moodie-shepherd enrolled in Medicare?
Yes. Jessie Moodie-shepherd is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jessie Moodie-shepherd's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jessie Moodie-shepherd reassigns Medicare benefits to Genesis Medical Health PC (Spring Valley, NY). The 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 Jessie Moodie-shepherd's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jessie Moodie-shepherd was last updated on July 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years 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.
# Jessie Dawn Moodie-Shepherd, NP · NPI 1578850376
Family physician in New York, New York. Individual provider, active in the CMS NPPES registry since June 30, 2011.
## Identity
- **NPI:** 1578850376 (Entity type: Individual)
- **Enumerated:** June 30, 2011
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F336664 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1 PENN PLZ, 8TH FLOOR, New York, NY 10119-0002
- **Phone:** (646) 761-1725
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Genesis Medical Health PC (NPI 1295043099, Spring Valley, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 28, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1578850376) · Data from the CMS NPPES public registry.