Individual provider Active NPI

Christine M. Moore, AA

  • Anesthesiologist Assistant
  • Middleburg Heights, OH
National Provider Identifier
1609102763
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
67.000159 Issued in OH
Practice address
18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone
(440) 816-6246
Fax
(440) 816-6263
NPI assigned
Oct 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 67.000159 OH Primary

Addresses

Primary practice location

18697 Bagley Rd
Middleburg Heights, OH 44130-3417

Mailing address

18697 Bagley Rd
Middleburg Heights, OH 44130-3417
Phone (440) 816-6246

Other identifiers 1

IdentifierTypeStateIssuer
3016462MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091209000333 OH Practitioner - Anesthesiology Assistant 1355480096 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest General Medical Group IncGroup PAC ID 8527964550, 232 clinicians
Elyria Anesthesia IncorporatedGroup PAC ID 7214902170, 64 clinicians

Practice addresses (Care Compare)

18697 Bagley Rd
Middlebrg HTS, OH 44130-3417
Phone (440) 816-8000

200 W Lorain St
Oberlin, OH 44074-1026
Phone (440) 323-8515

Hospital & facility affiliations

  • Southwest General Health Center Hospital, Middleburg Heights, OH, CCN 360155
  • Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172

Merit-based Incentive Payment System (MIPS)

Final score
81.06 of 100Reported as group
Quality
63.56
Promoting interoperability
100
Improvement activities
40
Cost
73.3

Merit-based Incentive Payment System (MIPS)

Final score
78.79 of 100Reported as group
Quality
71.01
Improvement activities
40
Cost
82.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest General Medical Group Inc Current Accepting new patients
Southwest General Medical Group, Inc CurrentSince Jan 1, 2024 Accepting new patients
Elyria Anesthesia Incorporated CurrentSince Oct 7, 2023 Accepting new patients
Southwest General Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Ohio Anesthesia Group, Inc CurrentSince Oct 26, 2009 Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

4665 Douglas Cir NW
Ste 100
Canton, OH 44718
Phone (330) 499-5700

630 E River St
Elyria, OH 44035
Phone (440) 329-7450

860 E Broad St
Ste I
Elyria, OH 44035
Phone (440) 323-8458

3700 Kolbe Rd
Lorain, OH 44053
Phone (440) 331-9520

7255 Old Oak Blvd
Ste C202
Middleburg Heights, OH 44130
Phone (440) 816-5390

15345 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 743-8000

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

19250 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 260-9970

200 W Lorain St
Oberlin, OH 44074
Phone (440) 775-1211

29000 Center Ridge Rd
Westlake, OH 44145
Phone (440) 414-6046

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1609102763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-6246",
            "fax_number": "440-816-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18697 BAGLEY RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441303417",
            "telephone_number": "440-816-6246",
            "fax_number": "440-816-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTINE",
        "middle_name": "M.",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "OH",
            "license": "67.000159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3016462",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.