Individual provider Active NPI

Jeremiah S Mossman, APRN CRNA

  • Certified Registered Nurse Anesthetist
  • Estero, FL
National Provider Identifier
1578055588
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9383766 Issued in FL
Practice address
21586 Belvedere LN
Estero, FL 33928
Phone
(478) 973-0824
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 9383766 FL Primary

Addresses

Primary practice location

21586 Belvedere LN
Estero, FL 33928

Mailing address

21586 Belvedere LN
Estero, FL 33928-7329
Phone (478) 973-0824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180802002642 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9931457256 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Dynamics LLCGroup PAC ID 3779832530, 883 clinicians

Practice addresses (Care Compare)

63 Barkley Cir
Suite 103
Fort Myers, FL 33907-4514
Phone (239) 275-8882

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9383766FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 10, 2023 Accepting new patients
SWF Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2022 Accepting new patients
Anesthesia & Pain Consultants of SW FL CurrentSince Jul 1, 2018 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
West Florida Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2022 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Nov 25, 2019 Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

63 Barkley Cir
Ste 103
Fort Myers, FL 33907
Phone (239) 275-8882

63 Barkley Cir
Ste 104
Fort Myers, FL 33907
Phone (239) 275-8452

12511 World Plaza Ln
Bldg 50
Fort Myers, FL 33907
Phone 2399392622 ext. 300

63 Barkley Cir
Fort Myers, FL 33907
Phone (941) 936-5400

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

7431 Gladiolus Dr
Fort Myers, FL 33908
Phone (239) 689-7000

4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8380 Riverwalk Park Blvd
Ste 220
Fort Myers, FL 33919
Phone (239) 215-4104

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

204B E 19th St
Panama City, FL 32405
Phone (850) 769-7599

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1578055588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21586 BELVEDERE LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339287329",
            "telephone_number": "478-973-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21586 BELVEDERE LN",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "33928",
            "telephone_number": "478-973-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSMAN",
        "first_name": "JEREMIAH",
        "middle_name": "S",
        "credential": "APRN CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9383766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.