Individual provider Active NPI

Theodore S Moche, CRNA

  • Certified Registered Nurse Anesthetist
  • Exeter, NH
National Provider Identifier
1972875540
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
065615-23 Issued in NH
Practice address
5 Alumni Dr
Core Anesthesia
Exeter, NH 03833-2128
Phone
(603) 580-6624
Fax
(603) 580-6620
NPI assigned
Jan 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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 065615-23 NH Primary

Addresses

Primary practice location

5 Alumni Dr
Core Anesthesia
Exeter, NH 03833-2128

Mailing address

PO Box 655
Exeter, NH 03833-0655

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150423001579 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800057522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5 Coliseum Ave
Suite 7
Nashua, NH 03063-3206
Phone (603) 689-9242

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novamed Surgery Center of Nashua, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 5, 2015 Accepting new patients
Novamed Surgery Center of Nashua, LLC CurrentSince Jan 5, 2015 Accepting new patients

Locations

867705 Reliable Pkwy
Chicago, IL 60686

5 Coliseum Ave
Nashua, NH 03063
Phone (603) 881-7141

5 Coliseum Ave
Ste 7
Nashua, NH 03063
Phone (603) 689-9242

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.

NPI Registry JSON

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1972875540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038330655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 ALUMNI DR",
            "address_2": "CORE ANESTHESIA",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038332128",
            "telephone_number": "603-580-6624",
            "fax_number": "603-580-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCHE",
        "first_name": "THEODORE",
        "middle_name": "S",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "065615-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.