Randall D. Moore, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

041318849 Issued in IL

Practice address

800 East Carpenter Street
Room 2K64
Springfield, IL 62769-0001

Phone

(217) 525-5643

Fax

(217) 544-2521

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in IL, KY2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
• Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
• Uchicago Medicine Adventhealth Hinsdale Hospital, Hinsdale, IL, CCN 140122
• Baptist Health Louisville Hospital, Louisville, KY, CCN 180130

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  IL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Professional Anesthesia Services of Kentucky PLLC

  • Anesthesiology Physician
  • Louisville, KY
  • NPI 1992212807

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  NPD (past)
• Decatur Memorial Hospital

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Sangamon Associated Anesthesiologists, S.C.

  • Certified Registered Nurse Anesthetist
  • Springfield, IL
  • NPI 1699712661

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Midwest Health

  • General Acute Care Hospital
  • Hinsdale, IL
  • NPI 1265465439
  Care Compare affiliation
• Adventist Midwest Health

  • Psychiatric Hospital Unit
  • Hinsdale, IL
  • NPI 1447270780
  Care Compare affiliation
• Copley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1295882561
  Care Compare affiliation
• Resurrection Medical Center - Chicago LLC

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1811735228
  Care Compare affiliation
• Baptist Healthcare System Inc.

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1265539498
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679562532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 EAST CARPENTER STREET",
            "address_2": "ROOM 2K64",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690001",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 EAST CARPENTER STREET",
            "address_2": "ROOM 2K64",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627690001",
            "telephone_number": "217-525-5643",
            "fax_number": "217-544-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RANDALL",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "041318849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE #",
            "identifier": "041318849",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AANA#",
            "identifier": "72807",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL APN LICENSE #",
            "identifier": "209-005619",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP - TRICARE",
            "identifier": "371115308",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "0841504038",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corey Moore, M.A., B,C.B.A.
• Jamie Moore, MOT, OTR/L
• Morgan Anne Moore
• Naija Capri Moore
• Nicol Moore
• Ross Aaron Moore, M.D.
• William Moore, MD
• Helen L Moose, CNM-MS
• William Edward Moredock, PH.D.
• Javier Moreno

• Certified Registered Nurse Anesthetist in Springfield, IL
• Providers in Springfield, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.