NPIMap

Individual provider Active NPI

Thomas Francis Moquin, CRNA

  • Certified Registered Nurse Anesthetist
  • Scappoose, OR
National Provider Identifier
1881693364
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
200060013CRNA Issued in OR
Practice address
33316 Hillcrest Dr
Scappoose, OR 97056-4318
Phone
(503) 970-6426
NPI assigned
Jul 18, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 200060013CRNA OR Primary

Addresses

Primary practice location

33316 Hillcrest Dr
Scappoose, OR 97056-4318

Mailing address

207 Rainbow Dr
PMB 10707
Livingston, TX 77399-2007
Phone (503) 970-6426

Other identifiers 2

IdentifierTypeStateIssuer
04188MedicaidOR
430067146MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200060013CRNAORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Anesthesia Associates PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Associates of Dunedin Past Accepting new patients
Essent PRMC LP Nurse Anesthetist, Certified Registered Past Accepting new patients
Providence Health & Service- Washington Past Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Portland Anesthesia Specialists LLC Past Accepting new patients
Jennifer Sassi PA Nurse Anesthetist, Certified Registered PastSince Feb 5, 2014 Accepting new patients
Medical Anesthesia and Pain Management Consultants, P.a. PastSince May 1, 2015 Accepting new patients
North American Partners in Anesthesia (Illinois), LLC Past Accepting new patients

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881693364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 RAINBOW DR",
            "address_2": "PMB 10707",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773992007",
            "telephone_number": "503-970-6426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33316 HILLCREST DR",
            "city": "SCAPPOOSE",
            "state": "OR",
            "postal_code": "970564318",
            "telephone_number": "503-970-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOQUIN",
        "first_name": "THOMAS",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "200060013CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04188",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430067146",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scappoose, OR

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.