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

Nicholas Jay Moore, MD

Individual provider Family Medicine Physician · NPI 1265727556

Nicholas Jay Moore, MD is a Sports Medicine in Novi, Michigan. Graduated from Medical College of Wisconsin in 2011, 15 years ago. Practices with Select Rehabilitation, LLC, a 2,028-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
15
Trained at
Medical College of Wisconsin
Licensed in
MI
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

26850 Providence Pkwy Ste 260
Novi, MI 48374-1256
Phone: (248) 465-5140
Fax: (248) 465-5141
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 28300 Orchard Lake Rd, Farmington Hills, MI 48334-3704 — (248) 539-8630
  • 1225 S Latson Rd Ste 380, Howell, MI 48843-7643 — (248) 465-5140

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence 4301108292 (MI)
Family Medicine Physician Taxonomy 207Q00000X · Licence 4301108292 (MI)

Record details

NPI number1265727556
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 14, 2011
Last updated in NPPESApril 16, 2019
Mailing address26850 Providence Pkwy Ste 260, Novi, MI 48374-1256

Medicare enrollment

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

Medicare specialtySPORTS MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2011 (15 years in practice)
Group practice Select Rehabilitation, Llc — 2028 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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