Individual provider Active NPI

Moriah Herazo, CAA

  • Anesthesiology Physician
  • Miami, FL
National Provider Identifier
1114406626
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
27108566 Issued in FL
Practice address
8900 N Kendall Dr
Miami, FL 33176-2118
Phone
(786) 596-1960
NPI assigned
Aug 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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 27108566 FL Primary

Addresses

Primary practice location

8900 N Kendall Dr
Miami, FL 33176-2118

Mailing address

19121 NW 11TH St
Pembroke Pines, FL 33029-2938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220308002377 AL Practitioner - Anesthesiology Assistant 9436498235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Huntsville Anesthesiology Consultants PCGroup PAC ID 0749171262, 18 clinicians

Practice addresses (Care Compare)

721 Madison Sest
Huntsville, AL 35801-4408
Phone (256) 880-6711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
27108566FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Huntsville Anesthesiology Consultants PC Anesthesiology CurrentSince Feb 28, 2022 Accepting new patients

Locations

721 Madison St SE
Huntsville, AL 35801
Phone (256) 533-4888

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1114406626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19121 NW 11TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330292938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 N KENDALL DR",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331762118",
            "telephone_number": "786-596-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERAZO",
        "first_name": "MORIAH",
        "name_prefix": "Mrs.",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "27108566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; 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.