Individual provider Active NPI

Sean Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Toledo, OH
National Provider Identifier
1821412719
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
COA.15510 Issued in OH
Practice address
2142 N Cove Blvd
Toledo, OH 43606-3895
Phone
(419) 824-7345
Fax
(419) 824-7359
NPI assigned
Feb 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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 COA.15510 OH Primary

Addresses

Primary practice location

2142 N Cove Blvd
Toledo, OH 43606-3895

Mailing address

5855 Monroe St
Sylvania, OH 43560-2269
Phone (419) 824-7345

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smoore16710@epicdirect.promedica.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140314001566 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315178332 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
COA.15510OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Current Accepting new patients
Promedica Central Physicians CurrentSince Dec 31, 2015 Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 1, 2023 Accepting new patients
Ohio Anesthesia Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 2, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Dec 31, 2015 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Apr 1, 2023 Accepting new patients
University Primary Care Practices Inc CurrentSince Apr 1, 2023 Accepting new patients

Locations

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

11100 Euclid Ave
Cleveland Heights, OH 44106

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

7007 Powers Blvd
Parma, OH 44129
Phone (440) 743-4000

1111 Hayes Ave
Sandusky, OH 44870
Phone (419) 557-7455

5855 Monroe St
Sylvania, OH 43560
Phone (419) 291-2273

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

36000 Euclid Ave
Willoughby Hills, OH 44094
Phone (440) 375-8166

Interoperability endpoints

  • Direct secure messaging: smoore233366@ehrdirect.uhhospitals.org

Organizations & group practices 7

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 1

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": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1821412719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 MONROE ST",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602269",
            "telephone_number": "419-824-7345",
            "fax_number": "419-824-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2142 N COVE BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436063895",
            "telephone_number": "419-824-7345",
            "fax_number": "419-824-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SEAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-12",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "COA.15510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoore16710@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.