Individual provider Active NPI

William M Moss, CRNA

  • Certified Registered Nurse Anesthetist
  • St Paul, MN
National Provider Identifier
1194785493
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R1352935 Issued in MN
Practice address
640 Jackson Street
Mail Stop 11503P
St Paul, MN 55101-2502
Phone
(651) 254-3456
Fax
(651) 254-3048
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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 R1352935 MN Primary

Addresses

Primary practice location

640 Jackson Street
Mail Stop 11503P
St Paul, MN 55101-2502

Mailing address

8100 34TH Ave S
21110Q
Bloomington, MN 55425-1672
Phone (952) 883-7961

Other identifiers 1

IdentifierTypeStateIssuer
861405900MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040513000214 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143210161 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southdale Anesthesiologists LLCGroup PAC ID 6709842461, 62 clinicians
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians
Anesthesiology, P.a.Group PAC ID 9335033034, 136 clinicians

Practice addresses (Care Compare)

4100 Minnesota Dr
Suite 200
Edina, MN 55435-5417
Phone (952) 996-9600

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

9875 Hospital Dr
Maple Grove, MN 55369-4648
Phone (763) 898-1000

Hospital & facility affiliations

  • Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004
  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
74.5
Promoting interoperability
100
Improvement activities
40
Cost
72.86

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Certified Anesthesia Care, Co. Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2020 Accepting new patients
Anesthesiology, P.a. Nurse Anesthetist, Certified Registered CurrentSince Jun 4, 2021 Accepting new patients
Regions Hospital CurrentSince Jan 1, 2004 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince Nov 20, 2020 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Nov 20, 2020 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Jan 15, 2021 Accepting new patients
Regions Hospital CurrentSince Jan 1, 2004 Accepting new patients
Southdale Anesthesiologists, LLC CurrentSince Feb 1, 2022 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients

Locations

9801 DuPont Ave S
Ste 100
Bloomington, MN 55431

9875 Hospital Dr
Maple Grove, MN 55369
Phone (763) 581-1000

9117 Lyndale Ave S
Minneapolis, MN 55420
Phone (952) 835-1235

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

4100 Minnesota Dr
Ste 200
Minneapolis, MN 55435
Phone (952) 996-9600

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

10709 Wayzata Blvd
Ste 100
Minnetonka, MN 55305
Phone (763) 553-1142

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2055 15th St N
Ste B
Saint Cloud, MN 56303
Phone (320) 258-6620

640 Jackson St
Stop 11503P
Saint Paul, MN 55101
Phone (651) 254-3456

640 Jackson St
Saint Paul, MN 55101
Phone (651) 221-2164

2950 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 275-3050

400 10th St E
Waconia, MN 55387

7125 Tamarack Rd
Ste 200
Woodbury, MN 55125
Phone (651) 748-4444

Organizations & group practices 9

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 2

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1194785493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-7961",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON STREET",
            "address_2": "MAIL STOP 11503P",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-3048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "R1352935",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861405900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.