Individual provider Active NPI

Diane Treza Moschouris

  • Certified Registered Nurse Anesthetist
  • Detroit, MI
National Provider Identifier
1619446176
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704294241 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(800) 653-6568
NPI assigned
Nov 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704294241 MI Primary
Certified Registered Nurse Anesthetist 367500000X 812962 NV

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

29205 Canal St
Novi, MI 48377-1985
Phone (586) 554-4130

Other practice location 1

6245 Inkster Rd
Garden City, MI 48135-4001
Phone (734) 458-3300

Other practice location 2

135 S Prospect St
Ypsilanti, MI 48198-7914
Phone (734) 547-4711

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200429001122 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971841792 Reassigns benefits to 16 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
Asa Staffing IncGroup PAC ID 3971898644, 146 clinicians
Miycrnas LLCGroup PAC ID 4981013257, 4 clinicians
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

29201 Telegraph Rd
Suite 315
Southfield, MI 48034-7646
Phone (248) 281-0028

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Hospital & facility affiliations

  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704294241MIMDCertified Registered Nurse Anesthetist
812962NVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Aas LLC CurrentSince Jan 1, 2022 Accepting new patients
Miycrnas LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2021 Accepting new patients
Mymichigan Medical Center Midland Nurse Anesthetist, Certified Registered CurrentSince Feb 24, 2025 Accepting new patients
Asa Staffing Inc Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2024 Accepting new patients
Macomb Anesthesia, PC CurrentSince Aug 1, 2022 Accepting new patients
Ascension Genesys Hospital CurrentSince Apr 30, 2023 Accepting new patients
Jawad a Shah, MD PC CurrentSince Nov 15, 2023 Accepting new patients
Northwestern Services, LLC CurrentSince Mar 1, 2021 Accepting new patients
Jawad a Shah MD PC CurrentSince Nov 15, 2023 Accepting new patients
Northstar Anesthesia of Michigan III PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 24, 2021 Accepting new patients
PSJ Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Apr 22, 2024 Accepting new patients
The Center for Gastrointestinal Health at Health Park LLC CurrentSince Mar 21, 2023 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Feb 24, 2025 Accepting new patients
Michigan Crnas Staffing LLC CurrentSince Mar 1, 2021 Accepting new patients
Henry Ford Health Genesys Hospital Nurse Anesthetist, Certified Registered CurrentSince Apr 30, 2023 Accepting new patients
Novi Aas LLC CurrentSince Mar 1, 2021 Accepting new patients
Environ Anesthesia, LLC. Nurse Anesthetist, Certified Registered CurrentSince Jul 20, 2022 Accepting new patients
Northwestern Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2021 Accepting new patients
Alliance Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 15, 2023 Accepting new patients
GLPS Staffing Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients

Locations (25 of 28)

7794 Solution Ctr
Chicago, IL 60677

949 National Ave
Ste 151
Lexington, KY 40502
Phone (859) 509-8399

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

43475 Dalcoma Dr
Ste 100
Clinton Twp, MI 48038
Phone (586) 263-5043

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

24420 Ford Rd
Dearborn Heights, MI 48127
Phone (313) 202-9400

30055 Northwestern Hwy
Ste L-60
Farmington Hills, MI 48334
Phone (248) 265-6555

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1845
Flint, MI 48507
Phone (810) 275-9152

600 Health Park Blvd
Ste E
Grand Blanc, MI 48439
Phone (810) 503-8210

1 Genesys Pkwy
Grand Blanc, MI 48439
Phone (810) 606-5733

1 Genesys Pkwy
#H
Grand Blanc, MI 48439

4024 Park East Ct SE
Grand Rapids, MI 49546
Phone (231) 592-3102

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

1030 N Monroe St
Ste 2
Monroe, MI 48162
Phone (734) 682-3309

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

25500 Meadowbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 477-0220

43422 W Oaks Dr
Novi, MI 48377
Phone (248) 229-4658

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

326 N Main St
Royal Oak, MI 48067
Phone (248) 584-7600

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

29201 Telegraph Rd
Ste 315
Southfield, MI 48034
Phone (248) 281-0028

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4

Organizations & group practices 20

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.

View all 20

Hospital & facility affiliations 5

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": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619446176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29205 CANAL ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771985",
            "telephone_number": "586-554-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "800-653-6568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6245 Inkster Rd",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481354001",
            "country_code": "US",
            "telephone_number": "734-458-3300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "135 S Prospect St",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481987914",
            "country_code": "US",
            "telephone_number": "734-547-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSCHOURIS",
        "first_name": "DIANE",
        "middle_name": "TREZA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704294241",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "812962",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.