| Mrs Alicia Brooke Moore, CRNA | |
|
16152 Windham, Fraser, MI 48026-2042 | |
| (586) 242-9562 | |
| Not Available |
| Full Name | Mrs Alicia Brooke Moore |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 18 Years |
| Location | 16152 Windham, Fraser, Michigan |
| 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 |
|---|---|---|---|
| 1144599523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 4704210341 (Michigan) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 4704210341 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Henry Ford Macomb Hospital | Clinton township, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Kuldip S Deogun Md Pc | 3678580966 | 7 |
| Eastern District Anesthesiology Pllc | 6507195419 | 33 |
| Henry Ford Macomb Hospital Corporation | 7911808381 | 304 |
| Entity Name | Ascension St John Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598896995 PECOS PAC ID: 3173424082 Enrollment ID: O20040130000407 |
| Entity Name | Macomb Anesthesia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639248206 PECOS PAC ID: 2860486388 Enrollment ID: O20040408001058 |
| Entity Name | Henry Ford Macomb Hospital Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528130739 PECOS PAC ID: 7911808381 Enrollment ID: O20040522000104 |
| Entity Name | Kuldip S Deogun Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548207467 PECOS PAC ID: 3678580966 Enrollment ID: O20060310000544 |
| Entity Name | Asa Staffing Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114378981 PECOS PAC ID: 3971898644 Enrollment ID: O20160818002713 |
| Entity Name | Eastern District Anesthesiology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396397741 PECOS PAC ID: 6507195419 Enrollment ID: O20190830002837 |
| Entity Name | Detroit Anesthesia Services Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225607393 PECOS PAC ID: 4880098946 Enrollment ID: O20210811002351 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Alicia Brooke Moore, CRNA 16152 Windham, Fraser, MI 48026-2042 Ph: (586) 242-9562 | Mrs Alicia Brooke Moore, CRNA 16152 Windham, Fraser, MI 48026-2042 Ph: (586) 242-9562 |