OMAR JISHI MOORE M.D. NPI 1487072245

NPI Information

  • NPI: 1487072245
  • Provider Name: OMAR JISHI MOORE, M.D.
  • Classification: Psychiatry & Neurology - 2084N0600X
  • Specialization: Clinical Neurophysiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3003 CLAIRE LN STE 100
    JACKSONVILLE, FL
    ZIP 32223
  • Phone: (904) 204-6585

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NPI Details

Omar Jishi Moore, M.D. is a clinical neurophysiology psychiatry neurology in Jacksonville, FL with 12 years of experience. The provider is clinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autonomic nervous system disorders using combined clinical evaluation and electrophysiologic testing such as electroencephalography (EEG), electromyography (EMG), and nerve conduction studies (NCS). Omar Jishi Moore, M.D. NPI is 1487072245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduation Year:2014

The provider's business location address is:

3003 CLAIRE LN STE 100
JACKSONVILLE, FL
ZIP 32223-667
Phone: (904) 204-6585
Fax: (850) 390-7195

The NPI 1487072245 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Measurement of brain wave activity with video (veeg), 61-84 hours with review and report by health care professional (HCPCS:95724)

The enumeration date for this NPI number is 3/30/2014 and was last updated on 8/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurologyEMC0001993MICHIGANNo
22084N0400XPsychiatry & NeurologyNeurology2023017851MISSOURINo
32084N0400XPsychiatry & NeurologyNeurology30235MISSISSIPPINo
42084N0400XPsychiatry & NeurologyNeurology2021-01752NORTH CAROLINANo
52084N0400XPsychiatry & NeurologyNeurologyT9017TEXASNo
62084N0400XPsychiatry & NeurologyNeurology92255GEORGIANo
72084N0400XPsychiatry & NeurologyNeurology036146539ILLINOISNo
82084N0400XPsychiatry & NeurologyNeurology330900LOUISIANANo
92084N0400XPsychiatry & NeurologyNeurology01090166AINDIANANo
102084N0400XPsychiatry & NeurologyNeurology44297ALABAMANo
112084N0400XPsychiatry & NeurologyNeurologyMD-49933IOWANo
122084N0600XPsychiatry & NeurologyClinical NeurophysiologyME13426FLORIDAYes
132084N0400XPsychiatry & NeurologyNeurology04-46192KANSASNo
142084N0400XPsychiatry & NeurologyNeurologyC0733KENTUCKYNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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