Individual provider Active NPI

Jonathan Kurtis Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Anchorage, AK
National Provider Identifier
1134842172
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
199497 Issued in AK
Practice address
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone
(907) 563-2662
NPI assigned
Sep 23, 2022
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 197941 AK
Registered Nurse 163W00000X 439888 OH
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X 199497 AK Primary

Addresses

Primary practice location

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Mailing address

2111 W Sterling Rd
Burbank, OH 44214-9562
Phone (330) 749-9474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OH, VT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20221104001000 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254708290 Reassigns benefits to 1 organization
I20250718003284 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254708290 Reassigns benefits to 6 organizations
I20260413001758 VT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254708290 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arlington Anesthesia Partners LLCGroup PAC ID 7618344698, 91 clinicians
Premier Anesthesia of Ohio LLCGroup PAC ID 3779714258, 123 clinicians
Copley Hospital IncGroup PAC ID 9234125766, shared by 2 NPIs, 61 clinicians
Anesthesia Associates of Lima IncGroup PAC ID 4486553013, 53 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (614) 561-5233

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

275 Taylor Station Rd
Columbus, OH 43213-2927
Phone (614) 751-4466

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

528 Washington Hwy
Morrisville, VT 05661-8973
Phone (802) 888-8888

730 W Market St
Lima, OH 45801-4602
Phone (419) 277-3361

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
197941AKMDRegistered Nurse
439888OHMDRegistered Nurse
199497AKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Oct 15, 2025 Accepting new patients
Diagnostic Pathology, LLC Single Specialty Current Accepting new patients
Alaska Native Tribal Health Consortium Single Specialty CurrentSince Oct 12, 2022 Accepting new patients
Lima Memorial Professional Corporation Single Specialty CurrentSince Oct 15, 2025 Accepting new patients
Anesthesia Associates of Lima Inc Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Mercer County Joint Township Community Hospital Single Specialty CurrentSince Nov 1, 2025 Accepting new patients
Arlington Anesthesia Partners LLC Single Specialty CurrentSince Aug 17, 2025 Accepting new patients
Mercer County Joint Township Community Hospital CurrentSince Nov 1, 2025 Accepting new patients
Premier Anesthesia of Ohio LLC Single Specialty CurrentSince May 8, 2025 Accepting new patients
Lima Memorial Joint Operating Company Single Specialty Past Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

2655 Northwinds Pkwy
Alpharetta, GA 30009
Phone (678) 690-7804

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

800 W Main St
Coldwater, OH 45828
Phone (419) 678-2341

275 Taylor Station Rd
Columbus, OH 43213
Phone (614) 566-9983

793 W State St
Columbus, OH 43222
Phone (614) 234-1862

L3688
Columbus, OH 43260

L3982
Columbus, OH 43260

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

730 W Market St
Lima, OH 45801
Phone (419) 226-4310

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1134842172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 W STERLING RD",
            "city": "BURBANK",
            "state": "OH",
            "postal_code": "442149562",
            "telephone_number": "330-749-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-563-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JONATHAN",
        "middle_name": "KURTIS",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "197941",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "439888",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "199497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.