Individual provider Active NPI

Daniel D Moos, CRNA

  • Certified Registered Nurse Anesthetist
  • Kearney, NE
National Provider Identifier
1174553051
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
100581 Issued in NE
Practice address
10 E 31St St
Kearney, NE 68847-2908
Phone
(308) 236-5506
Fax
(308) 236-7089
NPI assigned
Jul 4, 2006
Last updated
Sep 24, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 100581 NE Primary

Addresses

Primary practice location

10 E 31St St
Kearney, NE 68847-2908

Mailing address

PO Box 1771
Kearney, NE 68848-1771
Phone (308) 236-5506

Other identifiers 1

IdentifierTypeStateIssuer
47068752615MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100126000483 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486796620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kearney Anesthesia Associates PC Nurse Anesthetist, Certified Registered CurrentSince Dec 11, 1995 Accepting new patients
Doctors Anesthesia Group, P.C. Past Accepting new patients

Locations

10 E 31st St
Kearney, NE 68847
Phone (308) 234-5520

10 E 31st St
#H
Kearney, NE 68847
Phone (308) 865-7100

115 E 52nd St
Kearney, NE 68847
Phone (308) 236-5506

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1174553051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1771",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688481771",
            "telephone_number": "308-236-5506",
            "fax_number": "308-236-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 E 31ST ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472908",
            "telephone_number": "308-236-5506",
            "fax_number": "308-236-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOS",
        "first_name": "DANIEL",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "100581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068752615",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.