Individual provider Active NPI

Ekaterina Alexandra Mould, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbus, OH
National Provider Identifier
1922546639
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019431 Issued in OH
Practice address
111 S Grant Ave FL 3
Columbus, OH 43215-4701
Phone
(614) 566-9871
NPI assigned
Feb 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 316912 NC
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.019431 OH Primary

Addresses

Primary practice location

111 S Grant Ave FL 3
Columbus, OH 43215-4701

Mailing address

PO Box 7527
Dublin, OH 43017-0727
Phone (419) 520-2495

Other identifiers 1

IdentifierTypeStateIssuer
0205396MedicaidOH

Other names 1

  • Yekaterina Aleksandrovna Dreyzin Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emould805481@direct.ohiohealth.com OhioHealth Corporation

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170327000272 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385929710 Reassigns benefits to 1 organization
I20191007003589 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385929710

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

111 S Grant Ave
FL 3
Columbus, OH 43215-4701
Phone (614) 566-9871

Hospital & facility affiliations

  • Grant Medical Center Hospital, Columbus, OH, CCN 360017

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.019431OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jun 1, 2022 Accepting new patients
Ohiohealth Corporation Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2022 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

111 S Grant Ave
Fl 3
Columbus, OH 43215
Phone (614) 566-9871

Dept L3652
Columbus, OH 43260

Organizations & group practices 2

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": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1922546639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727",
            "telephone_number": "419-520-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GRANT AVE FL 3",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154701",
            "telephone_number": "614-566-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULD",
        "first_name": "EKATERINA",
        "middle_name": "ALEXANDRA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "316912",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019431",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205396",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emould805481@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Corporation",
            "address_1": "111 S Grant Ave Fl 3",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432154701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "YEKATERINA",
            "last_name": "DREYZIN",
            "middle_name": "ALEKSANDROVNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.