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

Michael K Moore, PA

Individual provider Physician Assistant · NPI 1396786612

Michael K Moore, PA is a Physician Assistant in Hackensack, New Jersey. Licensed in New Jersey. Registered with an NPI since 2006.

Licensed in
NJ
In the registry since
2006
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

30 Prospect Ave Faculty Practice Ofc
Hackensack, NJ 07601-1914
Phone: (201) 441-3349
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MP000518 (NJ)

Record details

NPI number1396786612
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 9, 2006
Last updated in NPPESJuly 13, 2026
Mailing address46 Madison Ave, Summit, NJ 07901-1555

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