Individual provider Active NPI

George Ralph Moseley, CRNA

  • Certified Registered Nurse Anesthetist
  • Eagle River, AK
National Provider Identifier
1366439879
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA-07829 Issued in OH
Practice address
17486 Yellowstone Dr
Eagle River, AK 99577-9019
Phone
(907) 726-0937
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA-07829 OH Primary
Certified Registered Nurse Anesthetist 367500000X 368 AK

Addresses

Primary practice location

17486 Yellowstone Dr
Eagle River, AK 99577-9019

Mailing address

17486 Yellowstone Dr
Eagle River, AK 99577-9019
Phone (907) 726-0937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170710000316 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8729034798 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
NA-07829OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP CurrentSince Jul 10, 2020 Accepting new patients
Endoscopy Center of Niagara, LLC CurrentSince May 1, 2021 Accepting new patients
Endoscopy Center of Western New York LLC CurrentSince May 1, 2021 Accepting new patients
Niagara Frontier Anesthesia Services LLP Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2017 Accepting new patients
Kettering Anesthesia Associates, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Chugach Anesthesia, LLC PastSince Dec 17, 2012 Accepting new patients
Alaska Spine Center, LLC Past Accepting new patients

Locations

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

200 Ohio St
Medina, NY 14103
Phone (585) 798-2000

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

6930 Williams Rd
Ste 3010
Niagara Falls, NY 14304
Phone (716) 284-3264

4185 Seneca St
Ste 11
West Seneca, NY 14224

60 Maple Rd
#2
Williamsville, NY 14221
Phone (716) 332-1000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1366439879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17486 YELLOWSTONE DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995779019",
            "telephone_number": "907-726-0937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17486 YELLOWSTONE DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995779019",
            "telephone_number": "907-726-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "GEORGE",
        "middle_name": "RALPH",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA-07829",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.