Individual provider Active NPI

Moriah Susanne Krason, MD

  • Pediatrics Physician
  • Salem, VA
National Provider Identifier
1265513683
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101240230 Issued in VA
Practice address
1802 Braeburn Dr
Salem, VA 24153-7357
Phone
(540) 772-3580
Fax
(540) 772-3785
NPI assigned
Oct 19, 2006
Last updated
Sep 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101240230 VA Primary
Military Health Care Provider 171000000X 0101240230 VA

Addresses

Primary practice location

1802 Braeburn Dr
Salem, VA 24153-7357

Mailing address

1802 Braeburn Dr
Salem, VA 24153-7357
Phone (540) 772-3580

Other identifiers 1

IdentifierTypeStateIssuer
1265513683MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181219000913 TX Practitioner - Pediatric Medicine 7618125733 Reassigns benefits to 1 organization
I20210210002876 VT Practitioner - Pediatric Medicine 7618125733 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Nov 1, 2018 Accepting new patients
Southwestern Vermont Medical Center Inc. Pediatrics Current Accepting new patients
Southwestern Vermont Medical Center Inc. CurrentSince Aug 1, 2024 Accepting new patients
Cherokee Nation CurrentSince Nov 1, 2018 Accepting new patients
Northeastern Vermont Regional Hospital, Inc CurrentSince Feb 8, 2021 Accepting new patients
Northeastern Vermont Regional Hospital Inc. CurrentSince Feb 8, 2021 Accepting new patients
Southwestern Vermont Medical Center, Inc CurrentSince Aug 1, 2024 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

100 Hospital Dr
#44
Bennington, VT 05201
Phone (802) 442-4509

140 Hospital Dr
Ste 116
Bennington, VT 05201
Phone (802) 447-1836

140 Hospital Dr
Ste 210
Bennington, VT 05201
Phone (802) 447-3930

97 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 748-3722

Interoperability endpoints

  • Direct secure messaging: moriah.krason.1@3744.direct.athenahealth.com

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, 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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1265513683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3580",
            "fax_number": "540-772-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 BRAEBURN DR",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537357",
            "telephone_number": "540-772-3580",
            "fax_number": "540-772-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRASON",
        "first_name": "MORIAH",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101240230",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101240230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265513683",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.