Tina Marie Moran, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704227573 Issued in MI

Practice address

27351 Dequindre Rd
Madison Heights, MI 48071-3487

Phone

(248) 967-7000

NPI assigned

Sep 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Three Rivers Wound and Hyperbaric Center Professional Limited LiabilGroup PAC ID 2466864384, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Preferred Care Home Health Services Home health agency, Fort Myers, FL, CCN 109423
• Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Three Rivers Wound and Hyperbaric Center Professional Limited Liabil

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Monroeville, PA
  • NPI 1588265094

  FL

  Medicare reassignment Care Compare group NPD
• Swallowing Diagnostics Inc

  • Internal Medicine Physician
  • Parkland, FL
  • NPI 1710954672
  Medicare reassignment NPD
• Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
  • NPI 1992742852
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventhealth Port Charlotte Inc

  • General Acute Care Hospital
  • Port Charlotte, FL
  • NPI 1760299093
  Care Compare affiliation
• Providia Home Care LLC.

  • Home Health Agency
  • Fort Myers, FL
  • NPI 1245409010
  Care Compare affiliation

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407042930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "48067",
            "telephone_number": "248-967-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27351 DEQUINDRE RD",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480713487",
            "telephone_number": "248-967-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6121 N Thesta St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937108603",
            "country_code": "US",
            "telephone_number": "559-439-7633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN750803",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704227573",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP18939",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "CA",
            "license": "NP18939",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704227573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kanchana Malaa Mohanram, PT
• Momentum Chiropractic
• Colleen Monaghan, LLMSW
• Andrea Beth Monkman, DDS
• Moonflower Counseling
• Joseph John Morehouse, D.O.
• Sharonda Marie Morgan, LPN
• Jacqueline Lorraine Morgante, RN
• Aimee Dianna Morin, M.S., BCBA, LBA
• Nekia Morris Cutright

• Acute Care Nurse Practitioner in Madison Heights, MI
• Providers in Madison Heights, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.