Individual provider Active NPI

Enock Nyamoti, CRNA

  • Certified Registered Nurse Anesthetist
  • Staten Island, NY
National Provider Identifier
1467842898
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
653713 Issued in NY
Practice address
355 Bard Ave
Staten Island, NY 10310-1664
Phone
(718) 818-1234
NPI assigned
Jan 22, 2015
Last updated
May 6, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2020038995 MO
Certified Registered Nurse Anesthetist 367500000X AP128147 TX
Certified Registered Nurse Anesthetist 367500000X 653713 NY Primary
Registered Nurse 163W00000X 653713 NY

Addresses

Primary practice location

355 Bard Ave
Staten Island, NY 10310-1664

Mailing address

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6026

Other practice location 1

100 W US Highway 60
Mountain View, MO 65548-8542
Phone (417) 934-7000

Other practice location 2

1605 Martin Springs Dr Ste 160
Rolla, MO 65401-3026
Phone (573) 458-6637

Other practice location 3

100 Hospital Dr
Lebanon, MO 65536-9210
Phone (417) 533-6026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170321000502 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325323033 Reassigns benefits to 2 organizations
I20210713001271 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 8325323033 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Missouri HB Medical Services LLCGroup PAC ID 2668813197, 77 clinicians

Practice addresses (Care Compare)

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone (573) 776-9290

315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone (660) 785-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020038995MOMDCertified Registered Nurse Anesthetist
AP128147TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Medical Management Corp Nurse Anesthetist, Certified Registered CurrentSince Mar 17, 2025 Accepting new patients
Midwest Anesthesia Providers S.C Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Missouri HB Medical Services, LLC CurrentSince May 23, 2025 Accepting new patients
Mercy Hospital Lebanon Past Accepting new patients

Locations

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

1324 Motor Pkwy
Ste 101
Islandia, NY 11749
Phone (516) 850-8143

16203 Jamaica Ave
Ste 200
Jamaica, NY 11432
Phone (347) 429-7699

300 Old Country Rd
Fl 4
Mineola, NY 11501
Phone (516) 747-9232

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 1

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1467842898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "LEBANON",
            "state": "MO",
            "postal_code": "655369210",
            "telephone_number": "417-533-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101664",
            "telephone_number": "718-818-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 W US Highway 60",
            "address_purpose": "LOCATION",
            "city": "Mountain View",
            "state": "MO",
            "postal_code": "655488542",
            "country_code": "US",
            "telephone_number": "417-934-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 Martin Springs Dr Ste 160",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654013026",
            "country_code": "US",
            "telephone_number": "573-458-6637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655369210",
            "country_code": "US",
            "telephone_number": "417-533-6026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYAMOTI",
        "first_name": "ENOCK",
        "name_prefix": "Dr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2020038995",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP128147",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "653713",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "653713",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.