DR. JAMES MARVIN JR. MOORE (ED.D.) – Clinical Psychologist, NPI 1134116544

DR. JAMES MARVIN JR. MOORE (ED.D.) is a healthcare provider. based in The villages, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials ED.D.. They hold a License No. PY3671 (FL). The NPI Number for DR. JAMES MARVIN JR. MOORE (ED.D.) is 1134116544

Main info

Male
51 Years Of Experience
Accepts Medicare Assignment
Name
DR. JAMES MARVIN JR. MOORE (ED.D.)
NPI
1134116544
Phone
(352) 409-7030
Address
3188 MANSFIELD ST
Enumeration Date
30 September 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7862447711
Graduation Year
1975 (51 years ago)
PAC ID
6406811298
Group Practice PAC ID
3476961368
Professional Enrollment ID
I20041122000090
Address ID
FL331301807MI66XXXSTXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for DR. JAMES MARVIN JR. MOORE (ED.D.)

  • 3188, Mansfield Street, The Villages - District 3, The Villages, Sumter County, Florida, 32162, United States

    THE VILLAGES, FL 321627448

    Phone: (352) 409-7030

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-11-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20041122000090IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour9815$0
90791Psychiatric diagnostic evaluation1312$0
View full utilization report →

Insurance plans in this area (ZIP 32162)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476961368View full group profile
NameSpecialtyState
Clinical PsychologistMT
Clinical PsychologistLA
Clinical Social WorkerFL
Nurse PractitionerFL
Clinical Social WorkerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Certified Nurse Midwife (Cnm)FL
Clinical Social WorkerMN

Reviews

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Frequently asked questions

What NPI should I save for DR. JAMES MARVIN JR. MOORE (ED.D.)?
Save NPI 1134116544 if you need a stable reference for DR. JAMES MARVIN JR. MOORE (ED.D.).
Is DR. JAMES MARVIN JR. MOORE (ED.D.) active in the national directory?
DR. JAMES MARVIN JR. MOORE (ED.D.)'s public NPI profile is in an active state.
What field does DR. JAMES MARVIN JR. MOORE (ED.D.) work in?
You can think of DR. JAMES MARVIN JR. MOORE (ED.D.) as practicing within Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where is DR. JAMES MARVIN JR. MOORE (ED.D.)'s primary listing?
We display The Villages, Florida because that is what the record indicates for DR. JAMES MARVIN JR. MOORE (ED.D.).
Is DR. JAMES MARVIN JR. MOORE (ED.D.) a real provider?
This page reflects official NPPES data for NPI 1134116544. Always confirm identity and privileges with the practice and licensing boards.

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