NPIMap

Individual provider Active NPI

Timothy John Moran, M.D.

  • Anesthesiology Physician
  • Wausau, WI
National Provider Identifier
1437328614
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
51443-20 Issued in WI
Practice address
425 Pine Ridge Blvd
Wausau, WI 54401-4123
Phone
(216) 445-2115
NPI assigned
Feb 21, 2008
Last updated
May 14, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 51443-20 WI Primary
Anesthesiology Physician 207L00000X 57.009196 OH

Addresses

Primary practice location

425 Pine Ridge Blvd
Wausau, WI 54401-4123

Mailing address

425 Pine Ridge Blvd
Wausau, WI 54401-4123
Phone (216) 445-2115

Other identifiers 1

IdentifierTypeStateIssuer
35112300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080802000107 WI Practitioner - Anesthesiology 0244304632 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Minnesota Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Wisconsin AnesthesiologyGroup PAC ID 5597667097, 57 clinicians

Practice addresses (Care Compare)

425 Pine Ridge Blvd
Suite 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Quality
87.9
Promoting interoperability
100
Improvement activities
40
Cost
73.87

Merit-based Incentive Payment System (MIPS)

Final score
79.11 of 100Reported as group
Quality
74.74
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.009196OHMDAnesthesiology Physician
51443-20WIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Aspirus Riverview Hospital & Clinics, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Oct 16, 2023 Accepting new patients
Central Wisconsin Anesthesiology Anesthesiology CurrentSince Jul 7, 2008 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

425 Pine Ridge Blvd
Ste 21
Wausau, WI 54401

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505

420 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-7474

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1437328614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "216-445-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "216-445-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "TIMOTHY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "51443-20",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "57.009196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35112300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

Verify at the official NPI Registry.