Alicia Brooke Moore, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704210341 Issued in MI

Practice address

16152 Windham
Fraser, MI 48026-2042

Phone

(586) 242-9562

NPI assigned

Dec 14, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eastern District Anesthesiology PLLCGroup PAC ID 6507195419, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amoore4456@direct.hfhs.org

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.

• Eastern District Anesthesiology PLLC

  • Anesthesiology Physician
  • Rochester Hills, MI
  • NPI 1396397741

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Asa Staffing Inc

  • Certified Registered Nurse Anesthetist
  • Rochester, MI
  • NPI 1114378981

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Detroit Anesthesia Services PLLC

  • Anesthesiology Physician
  • Detroit, MI
  • NPI 1225607393
  Medicare reassignment NPD
• Henry Ford Health St. John Hospital

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
  • NPI 1598896995

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Clinton Township, MI
  • NPI 1528130739

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Kuldip S. Deogun, MD, PC

  • Interventional Pain Medicine Physician
  • Sterling Heights, MI
  • NPI 1548207467
  Medicare reassignment NPD
• Macomb Anesthesia, PC

  • Anesthesiology Physician
  • Clinton Township, MI
  • NPI 1639248206
  Medicare reassignment NPD
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD
• Henry Ford Health St. John Hospital

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1023088168
  NPD

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1144599523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16152 WINDHAM",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480262042",
            "telephone_number": "586-242-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16152 WINDHAM",
            "city": "FRASER",
            "state": "MI",
            "postal_code": "480262042",
            "telephone_number": "586-242-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALICIA",
        "middle_name": "BROOKE",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-14",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704210341",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704210341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Ivica Mihelic, RPH
• James C Miller III, OD
• Monir Mina, D.D.S.
• Lisa Marie Miranti
• Kyla C Monette
• Ashley Morin
• Robert J Morris, M.D.
• Davinder Mudan, DMD
• Matthew P Mullan, D.D.S.
• Lata Nair-Brown, OTR/L

• Certified Registered Nurse Anesthetist in Fraser, MI
• Providers in Fraser, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.