Individual provider Active NPI

Elaina Susan Moss, RN

  • Certified Registered Nurse Anesthetist
  • Minneapolis, MN
National Provider Identifier
1811223738
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
764 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(865) 342-8900
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R1695582 MN
Certified Registered Nurse Anesthetist 367500000X 083446 NC
Certified Registered Nurse Anesthetist 367500000X 764 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

4301 Manor Field Way Apt 104
Raleigh, NC 27612-3776
Phone (763) 228-0783

Other identifiers 1

IdentifierTypeStateIssuer
8053817MedicaidNC

Other names 1

  • Elaina Susan Fussy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000239 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436294071 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians
Mngi Digestive Health PAGroup PAC ID 8123016557, 276 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

3001 Broadway St NE
Suite 500
Minneapolis, MN 55413-2197
Phone (612) 871-1145

Hospital & facility affiliations

  • Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1695582MNMDRegistered Nurse
764MNMDCertified Registered Nurse Anesthetist
083446NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System Current Accepting new patients
Mngi Digestive Health, P.a. CurrentSince Nov 2, 2021 Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Jan 27, 2025 Accepting new patients
University Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince May 4, 2020 Accepting new patients

Locations

5705 W Old Shakopee Rd
Ste 150
Bloomington, MN 55437
Phone (612) 870-5530

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

1185 Town Centre Dr
Ste 205
Eagan, MN 55123

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

3001 Broadway St NE
Ste 500
Minneapolis, MN 55413
Phone (612) 870-5557

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

8100 W 78th St
Ste 220
Minneapolis, MN 55439
Phone (952) 914-8400

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

15700 37th Ave N
Plymouth, MN 55446
Phone (763) 577-0008

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811223738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 MANOR FIELD WAY APT 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123776",
            "telephone_number": "763-228-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "865-342-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "ELAINA",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R1695582",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "083446",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8053817",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINA",
            "last_name": "FUSSY",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.