Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob W Moore Jr., NP

Individual provider Adult Health Nurse Practitioner · NPI 1023165610

Jacob W Moore Jr., NP is a Nurse Practitioner in Honolulu, Hawaii. Qualified in 2000, 26 years ago. Practices with Queens University Medical Group, a 623-clinician group and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
26
Licensed in
HI
In the registry since
2007
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

550 S Beretania St Ste 601
Honolulu, HI 96813-2423
Phone: (808) 691-8877
Fax: (808) 691-8875
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence APRN-558 (HI)

Record details

NPI number1023165610
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 4, 2007
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Queens University Medical Group — 623 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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