Michelle Lee Moylan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

R135096 Issued in MD

Practice address

305 Wye Harbor Dr
Queenstown, MD 21658-1638

Phone

(410) 703-1111

NPI assigned

May 27, 2006

Last updated

Dec 28, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MLM Anesthesia LLC

  • Anesthesiology Physician
  • Timonium, MD
  • NPI 1366072605
  Medicare reassignment NPD Authorized official
• Advanced Center for Plastic Surgery

  • Plastic and Reconstructive Surgery Physician
  • Timonium, MD
  • NPI 1770501330
  NPD (past)
• Beverly a Fischer MD P a

  • Ambulatory Surgical Clinic/Center
  • Timonium, MD
  • NPI 1053664136
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577491200000",
    "number": "1043267115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 WYE HARBOR DR",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "216581638",
            "telephone_number": "410-703-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 WYE HARBOR DR",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "216581638",
            "telephone_number": "410-703-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "782 Marston Ct",
            "address_purpose": "LOCATION",
            "city": "Millersville",
            "state": "MD",
            "postal_code": "211081499",
            "country_code": "US",
            "telephone_number": "410-703-1111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2019-12-28",
        "certification_date": "2019-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R135096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556224401",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maryland Primary Care Physicians, LLC
• Mid Atlantic Cat Hospital
• Naryah Miles, LCSW-C
• Sallie Miller, LCSWC
• Mikayla Mountain, CCC-SLP
• Christina Anne Palmer, OTR/L
• Michael Ryan Persch, MD
• Queenstown Volunteer Fire Company
• Queenstown Volunteer Fire Department Inc
• Geneva Frances Rieu, LCSW-C

• Certified Registered Nurse Anesthetist in Queenstown, MD
• Providers in Queenstown, MD by specialty
• Certified Registered Nurse Anesthetist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.