Individual provider Active NPI

Carlos L Moreno, MD

  • Anesthesiology Physician
  • Tulare, CA
National Provider Identifier
1962468561
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A86872 Issued in CA
Practice address
869 N. Cherry Street
Tulare, CA 93274-2207
Phone
(209) 668-0821
Fax
(269) 659-6738
NPI assigned
Apr 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A86872 CA Primary
Anesthesiology Physician 207L00000X 4301072895 MI

Addresses

Primary practice location

869 N. Cherry Street
Tulare, CA 93274-2207

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 1

IdentifierTypeStateIssuer
4830843MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220424000006 NY Practitioner - Anesthesiology 9739153248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Oregon Health Sciences University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ramapo Anesthesiologists, PCGroup PAC ID 3476444373, 78 clinicians

Practice addresses (Care Compare)

68 Harris Bushville Rd
Monticello, NY 12701-3027
Phone (845) 357-5775

Hospital & facility affiliations

  • Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ramapo Anesthesiologists, PC Anesthesiology CurrentSince Mar 13, 2023 Accepting new patients
MVHS Inc CurrentSince Apr 1, 2022 Accepting new patients
MVHS Inc CurrentSince Apr 1, 2022 Accepting new patients
Central Anesthesia Services, PC Anesthesiology Past Accepting new patients
Bell Medical Center Past Accepting new patients

Locations

68 Harris Bushville Rd
Monticello, NY 12701
Phone (845) 897-6053

233 Lafayette Ave
Ste LL5
Suffern, NY 10901
Phone (914) 794-7741

2209 Genesee St
Ofc
Utica, NY 13501
Phone (315) 801-3282

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Organizations & group practices 5

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 2

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": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1962468561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "869 N. CHERRY STREET",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932742207",
            "telephone_number": "209-668-0821",
            "fax_number": "269-659-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CARLOS",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A86872",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301072895",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4830843",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulare, CA

Sources for this page

Verify at the official NPI Registry.