Individual provider Active NPI

Stephanie Moura, M.D.

  • Anesthesiology Physician
  • Suffern, NY
National Provider Identifier
1043741804
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
300146 Issued in NY
Practice address
255 Lafayette Ave
Suffern, NY 10901-4812
Phone
(845) 357-5775
Fax
(845) 357-5777
NPI assigned
Mar 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 300146 NY Primary

Addresses

Primary practice location

255 Lafayette Ave
Suffern, NY 10901-4812

Mailing address

100 Route 59 Ste 111
Suffern, NY 10901-5620
Phone (845) 357-5775

Other names 1

  • Stephanie Hernandez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210804001435 NY Practitioner - Anesthesiology 0547507857 Reassigns benefits to 1 organization
I20260130001449 NJ Practitioner - Anesthesiology 0547507857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
New York Medical College, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ramapo Anesthesiologists, PCGroup PAC ID 3476444373, 78 clinicians

Practice addresses (Care Compare)

255 Lafayette Ave
Suffern, NY 10901-4812
Phone (845) 357-5775

Hospital & facility affiliations

  • Good Samaritan Hospital of Suffern Hospital, Suffern, NY, CCN 330158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
300146NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Ramapo Anesthesiologists, PC Anesthesiology CurrentSince Aug 2, 2021 Accepting new patients
Centurion Anesthesia Surgical Centers LLC Anesthesiology CurrentSince Dec 20, 2025 Accepting new patients
Gastrointestinal Care of Long Island PLLC PastSince Mar 10, 2025 Accepting new patients

Locations

1 N Washington Ave
Ste A
Bergenfield, NJ 07621
Phone (201) 374-2829

321 Essex St
Hackensack, NJ 07601
Phone (201) 692-9800

225 Sunset Rd
Willingboro, NJ 08046
Phone (609) 877-2800

500 New Hempstead Rd
Ste A
New City, NY 10956
Phone (845) 362-3200

974 Route 45
Ste 1000
Pomona, NY 10970
Phone (845) 354-1113

974 Route 45
Ste 2000
Pomona, NY 10970
Phone (845) 354-3700

100 Route 59
Ste 111
Suffern, NY 10901
Phone (845) 369-9701

255 Lafayette Ave
Suffern, NY 10901
Phone (845) 357-7830

233 Lafayette Ave
Ste LL5
Suffern, NY 10901
Phone (914) 794-7741

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1043741804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROUTE 59 STE 111",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109015620",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 LAFAYETTE AVE",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109014812",
            "telephone_number": "845-357-5775",
            "fax_number": "845-357-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURA",
        "first_name": "STEPHANIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "300146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "HERNANDEZ",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Suffern, NY

Sources for this page

Verify at the official NPI Registry.