| Janice Moore, CRNA | |
|
200 High Park Ave, Goshen, IN 46526-4810 | |
| (317) 340-8384 | |
| Not Available |
| Full Name | Janice Moore |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 200 High Park Ave, Goshen, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114271327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28147329A (Indiana) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 209012796 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Goshen Hospital | Goshen, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Australia Anesthesia Management Llc | 9436671864 | 39 |
| Entity Name | Southeast Anesthesiologists, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548210685 PECOS PAC ID: 6800837980 Enrollment ID: O20050518001265 |
| Entity Name | Australia Anesthesia Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700601903 PECOS PAC ID: 9436671864 Enrollment ID: O20250314002290 |
| Mailing Address | Practice Location Address |
|---|---|
| Janice Moore, CRNA 450 E 96th St Ste 200, Indianapolis, IN 46240-3797 Ph: () - | Janice Moore, CRNA 200 High Park Ave, Goshen, IN 46526-4810 Ph: (317) 340-8384 |
Derek S Poulson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 57809 Hillside Dr, Goshen, IN 46528 Phone: 801-623-7813 | |
Katherine Ann Newcomer, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 574-364-1000 | |
Brett Dyer, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 20208 Deer Path Ct., Goshen, IN 46528 Phone: 801-864-0218 |