DR. JACOB ALEXANDER MOORE PH.D.
NPI 1821762220
Psychologist - Counseling in Rockville, MD

Active since August 09, 2021PECOS EnrolledAccepts Medicare Assignment
9707 KEY WEST AVE STE 100, ROCKVILLE, MD 20850(240) 750-6467 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 7, 2025, Aug 9, 2021 (2 updates tracked since 2021).

About Dr. Jacob Alexander Moore Ph.d. NPPES

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

DR. JACOB ALEXANDER MOORE PH.D. (NPI 1821762220) is an individual counseling provider in Rockville, Maryland, licensed in Maryland (07251) and active in the NPI registry since August 2021. He is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1821762220
Entity TypeIndividualMale
Primary Taxonomy103TC1900X
Provider Legal NameDR. JACOB ALEXANDER MOORECredential: PH.D.
Location Address9707 KEY WEST AVE STE 100Rockville, MD 20850-3992
Mailing Address5822 Barnwood PlColumbia, MD 21044-2842 · (301) 272-5080
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateAugust 9, 2021
Last NPPES UpdateMarch 7, 20252 updates tracked since enumeration
NPPES CertifiedMarch 7, 2025
✔ NPI 1821762220 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · CounselingBehavioral Health & Social Service Providers
Taxonomy Code103TC1900X
License✔ Licensed in MD · 07251
Definition
A psychologist who specializes in general practice and health service. It focuses on how people function both personally and in their relationships at all ages. Counseling psychology addresses the emotional, social, work, school and physical health concerns people may have at different stages in their lives, focusing on typical life stresses and more severe issues with which people may struggle as individuals and as a part of families, groups and organizations. Counseling psychologists help people with physical, emotional and mental health issues improve their sense of well-being, alleviate feelings of distress and resolve crises. They also provide assessment, diagnosis, and treatment of more severe psychological symptoms.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License A0611 (MD)
9707 KEY WEST AVE STE 100, Rockville, MD 20850

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. Jacob Alexander Moore Ph.d. 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 ID2567988355
PECOS Enrollment IDI20250424001729, I20250428003235
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 Reassignments

2

Medicare enrollment records show Jacob Moore reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychiatry
9707 KEY WEST AVE STE 100
Rockville, MD 20850
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • 44 clinicians in this Medicare group
Psychiatry
30 GREENWAY ST NW, SUITE 5
Glen Burnie, MD 21061
  • Reassigned Medicare billing, District of Columbia enrollment
  • 26 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.

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.

Counselor (Professional)
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Psychologist
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Counselor (Mental Health)
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Counselor (Mental Health)
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Counselor
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Counselor (Mental Health)
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Counselor (Mental Health)
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850
Psychologist
9707 KEY WEST AVE STE 100
ROCKVILLE, MD 20850

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 Jacob Moore's NPI number?

The NPI number for Jacob Moore is 1821762220. It was assigned to this individual provider in the NPPES registry on August 9, 2021.

Where is Jacob Moore located?

Jacob Moore practices at 9707 Key West Ave Ste 100, Rockville, MD 20850. The listed phone number is (240) 750-6467.

What is Jacob Moore's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Counseling, with taxonomy code 103TC1900X.

Is Jacob Moore enrolled in Medicare?

Yes. Jacob 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 Jacob Moore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacob Moore reassigns Medicare benefits to 2 organizations: Quince Orchard Psychotherapy LLC (Rockville, MD) and Oasis The Mental Health Center, LLC (Glen Burnie, MD). 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 Jacob 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 Jacob Moore was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.