DR. MARK MOORE PHD
NPI 1669690905
Psychologist - Prescribing (Medical) in Philadelphia, PA

Q: What is Mark Moore's NPI number?

The NPI number for Mark Moore is 1669690905. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Q: What is Mark Moore's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

Q: When was this NPI record last updated?

The NPPES record for Mark Moore was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.

Active since April 23, 2007PECOS EnrolledAccepts Medicare Assignment

230 W WASHINGTON SQ, 2ND FLOOR, PHILADELPHIA, PA 19106(215) 829-6088(215) 829-6104 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: November 01, 2026.

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About Dr. Mark Moore Phd NPPES

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

DR. MARK MOORE PHD (NPI 1669690905) is an individual prescribing (medical) provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (PS015627) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2003).

NPPES Registry Identity

NPI1669690905

Entity TypeIndividualMale

Primary Taxonomy103TP0016X

Provider Legal NameDR. MARK MOORECredential: PHD

Location Address230 W WASHINGTON SQ, 2ND FLOORPhiladelphia, PA 19106-3500

Mailing Address230 W Washington Sq, 2nd FloorPhiladelphia, PA 19106-3500 · (215) 829-6088 · Fax (215) 829-6104

Phone(215) 829-6088

Fax(215) 829-6104

Sole ProprietorNo

Medical School CMSOtherGraduated 2003

Enumeration DateApril 23, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1669690905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Prescribing (Medical)Behavioral Health & Social Service Providers

Taxonomy Code103TP0016X

License✔ Licensed in PA · PS015627

Definition

A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.

230 W WASHINGTON SQ, Philadelphia, PA 19106

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Other Identifiers 1

Medicare ID-Type Unspecified093895MC4PA

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. Mark Moore Phd 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 ID7416989751

PECOS Enrollment IDI20050907000734

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Mark Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Moore Psychotherapy Care LLC

1.4 mi

Clinical

2400 CHESTNUT ST APT 2810
Philadelphia, PA 19103

Reassigned Medicare billing, Pennsylvania enrollment

NPI 1265856447 (267) 879-4110

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

MELISSA HELLER

Counselor

230 W WASHINGTON SQ
PHILADELPHIA, PA 19106

Philadelphia County (267) 624-3847

AMARYAH YAEGER CRNP

Nurse Practitioner (Acute Care)

230 W WASHINGTON SQ
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-5064

KWABENA ADU NTOSO MD

Internal Medicine (Nephrology)

230 W WASHINGTON SQ, SUITE 100
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-8420

BRYAN MATTHEW BLANCHARD CRNP

Nurse Practitioner (Acute Care)

230 W WASHINGTON SQ
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-8713

PENNSYLVANIA NEPHROLOGY ASSOCIATES, P.C.

Internal Medicine (Nephrology)

230 W WASHINGTON SQ, SUITE 100
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-8420

DR. ROBERT K WENGER MD

Thoracic Surgery (Cardiothoracic Vascular Surgery)

230 W WASHINGTON SQ
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-8713

FREDERICK A NUNES MD

Internal Medicine (Gastroenterology)

230 W WASHINGTON SQ, FARM JOURNAL BUILDING, FL 4
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3561

CLINICAL HEALTH CARE ASSOCIATES OF NEW JERSEY, PC

Orthopaedic Surgery (Foot and Ankle Surgery)

230 W WASHINGTON SQ, 5TH FLOOR
PHILADELPHIA, PA 19106

Philadelphia County (215) 829-3668

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 Mark Moore's NPI number?

The NPI number for Mark Moore is 1669690905. It was assigned to this individual provider in the NPPES registry on April 23, 2007.

Where is Mark Moore located?

Mark Moore practices at 230 W Washington Sq 2nd Floor, Philadelphia, PA 19106. The listed phone number is (215) 829-6088.

What is Mark Moore's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Prescribing (Medical), with taxonomy code 103TP0016X.

Is Mark Moore enrolled in Medicare?

Yes. Mark 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 organization bills Medicare for Mark Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mark Moore reassigns Medicare benefits to Moore Psychotherapy Care LLC (Philadelphia, PA). 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 Mark Moore'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 Mark Moore was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.