Individual provider Active NPI

Charles A Moores, CRNA

  • Certified Registered Nurse Anesthetist
  • Coeur D Alene, ID
National Provider Identifier
1760445910
Registry record updated Sep 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA468 Issued in ID
Practice address
2204 Ironwood PL Ste B
Coeur D Alene, ID 83814-2662
Phone
(208) 765-8585
Fax
(208) 765-8486
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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 RNA468 ID Primary

Addresses

Primary practice location

2204 Ironwood PL Ste B
Coeur D Alene, ID 83814-2662

Mailing address

2204 Ironwood PL
Ste B
Coeur D Alene, ID 83814-2662
Phone (208) 762-7487

Other identifiers 1

IdentifierTypeStateIssuer
806221900MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, ID, NM, MT4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20040420000276 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709871569 Reassigns benefits to 1 organization
I20100826000527 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709871569 Reassigns benefits to 2 organizations
I20180222000454 NM Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709871569 Reassigns benefits to 1 organization
I20241115002365 MT Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709871569 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Netherlands Anesthesia, LLCGroup PAC ID 8123433588, 41 clinicians
Marcus Daly Memorial Hospital CorporationGroup PAC ID 5597664474, 97 clinicians

Practice addresses (Care Compare)

104 Legion Dr
Las Vegas, NM 87701-4804
Phone (505) 426-3500

1200 Westwood Dr
Hamilton, MT 59840-2345
Phone (406) 363-2211

Hospital & facility affiliations

  • Bitterroot Health - Daly Hospital Hospital, Hamilton, MT, CCN 271340
  • Holy Cross Hospital a Div of Taos Health Systems Hospital, Taos, NM, CCN 321310

Merit-based Incentive Payment System (MIPS)

Final score
96.72 of 100Reported as apm
Quality
84.31
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
69.27 of 100Reported as group
Quality
24.16
Promoting interoperability
100
Improvement activities
40
Cost
73.41

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RNA468IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia Hawaii, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2020 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
Marcus Daly Memorial Hospital Corporation Current Accepting new patients
Anesthesia Associates of Coeur D Alene PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2001 Accepting new patients
Netherlands Anesthesia, LLC CurrentSince Jul 7, 2025 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Sep 2, 2024 Accepting new patients
Marcus Daly Memorial Hospital Corporation CurrentSince Sep 2, 2024 Accepting new patients
Teton Valley Health Care Inc Past Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Medical Imaging Associates of Idaho Falls, Inc Past Accepting new patients

Locations

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

2204 N Ironwood Pl
Ste B
Coeur D Alene, ID 83814
Phone (208) 765-8585

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

1224 W Main St
Hamilton, MT 59840
Phone (406) 375-4823

1200 Westwood Dr
Hamilton, MT 59840
Phone (406) 363-2211

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

104 Legion Dr
Las Vegas, NM 87701
Phone (505) 426-3500

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

Interoperability endpoints

  • Direct secure messaging: charles.moores.1@15468.direct.athenahealth.com

Organizations & group practices 17

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 17

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1760445910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 IRONWOOD PL",
            "address_2": "STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142662",
            "telephone_number": "208-762-7487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 IRONWOOD PL STE B",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142662",
            "telephone_number": "208-765-8585",
            "fax_number": "208-765-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORES",
        "first_name": "CHARLES",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806221900",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.