DR. CHARLES N JR. MOORE (D.MIN.) – Family Psychologist, NPI 1104988500

DR. CHARLES N JR. MOORE (D.MIN.) is a healthcare provider. based in Essex, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials D.MIN.. They hold a License No. 2097 (MA). The NPI Number for DR. CHARLES N JR. MOORE (D.MIN.) is 1104988500

Main info

Male
Sole Proprietor
52 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHARLES N JR. MOORE (D.MIN.)
NPI
1104988500
Phone
(978) 884-8641
Address
23 SPRING ST
Enumeration Date
14 December 2006
Last Update Date
11 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7185061115
Graduation Year
1974 (52 years ago)
PAC ID
8022456326
Group Practice PAC ID
8123530169
Professional Enrollment ID
I20240405000883
Address ID
MA019704267SA7XXXXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

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Provider Addresses for DR. CHARLES N JR. MOORE (D.MIN.)

  • 23, Spring Street, South Essex, Essex, Essex County, Massachusetts, 01929, United States

    ESSEX, MA 019291311

    Phone: (978) 884-8641

    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: 2024-04-05

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
I20240405000883IClinical PsychologistMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 01929)

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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: 8123530169View full group profile
NameSpecialtyState
Mental Health CounselorMA
Clinical Social WorkerMA
Clinical Social WorkerMA
Mental Health CounselorMA
Clinical PsychologistMA
Clinical PsychologistMA
Mental Health CounselorNE
Mental Health CounselorMA
Clinical Social WorkerMA
Mental Health CounselorMA

Reviews

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Frequently asked questions

What is the registry number for DR. CHARLES N JR. MOORE (D.MIN.)?
The registry entry for DR. CHARLES N JR. MOORE (D.MIN.) shows NPI 1104988500.
Is DR. CHARLES N JR. MOORE (D.MIN.) currently accepting referrals based on NPI status?
Registry metadata lists DR. CHARLES N JR. MOORE (D.MIN.) as active.
What type of care does DR. CHARLES N JR. MOORE (D.MIN.) provide?
DR. CHARLES N JR. MOORE (D.MIN.)'s profile centers on Family Psychologist. Clinical services aligned with this taxonomy classification.
Can patients visit DR. CHARLES N JR. MOORE (D.MIN.) in Essex, Massachusetts?
For routing, start with Essex, Massachusetts for DR. CHARLES N JR. MOORE (D.MIN.), then verify phone and hours locally.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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