Individual provider Active NPI

Martin F Moran, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1891771002
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN324658L Issued in PA
Practice address
2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542
Phone
(215) 952-9323
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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 RN324658L PA Primary

Addresses

Primary practice location

2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542

Mailing address

2301 S Broad St
1St Floor
Philadelphia, PA 19148-3542
Phone (215) 952-9323

Other identifiers 1

IdentifierTypeStateIssuer
001968600MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141106001492 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072540152 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Pennsylvania, LLC Anesthesiology CurrentSince Jan 1, 2020 Accepting new patients
Martin J. Moran Sr., D.O., P.C. PastSince Jul 1, 2001 Accepting new patients
Professional Anesthesia Consultants, PC Anesthesiology PastSince Jan 2, 2005 Accepting new patients
Hamilton Gastroenterology Group, P.C. Past Accepting new patients

Locations

1000 Dutch Ridge Rd
Beaver, PA 15009
Phone (724) 728-7000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1891771002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S BROAD ST",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483542",
            "telephone_number": "215-952-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MARTIN",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN324658L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001968600",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.