Mrs Nicole Antonia Moreno, CRNA in Jackson, MI - Medicare Nurse Anesthetist, Certified Registered

Mrs Nicole Antonia Moreno, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Jackson, Michigan. Her current practice location is 205 North East Avenue, Anesthesia Department, Jackson, Michigan. You can reach out to her office (for appointments etc.) via phone at (517) 205-4963.

Mrs Nicole Antonia Moreno is licensed to practice in Michigan (license number 4704289793) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1316471535.

Contact Information

	Mrs Nicole Antonia Moreno, CRNA
	205 North East Avenue, Anesthesia Department, Jackson, MI 49201
	(517) 205-4963
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Nicole Antonia Moreno
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	205 North East Avenue, Jackson, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1316471535
Provider Enumeration Date: 04/13/2017
Last Update Date: 03/30/2021

Medicare PECOS Information:

PECOS PAC ID: 1052688819
Enrollment ID: I20170525002711

Medical Identifiers

Medical identifiers for Mrs Nicole Antonia Moreno such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316471535	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	4704289793 (Michigan)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Nicole Antonia Moreno allows following entities to bill medicare on her behalf.

Entity Name	W.a. Foote Memorial Hospital, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1598776718 PECOS PAC ID: 0244136067 Enrollment ID: O20031215000624

Entity Name	Capital Area Anesthesia Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538105010 PECOS PAC ID: 8628975968 Enrollment ID: O20031216000210

Entity Name	Henry Ford Health System
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871666479 PECOS PAC ID: 0547178311 Enrollment ID: O20040124000368

Entity Name	Edward W Sparrow Hospital Association
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366498107 PECOS PAC ID: 6709799166 Enrollment ID: O20040311001138

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Nicole Antonia Moreno is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mrs Nicole Antonia Moreno, CRNA Po Box 67000, Dept 272801, Detroit, MI 48264-0001 Ph: (517) 205-4963	Mrs Nicole Antonia Moreno, CRNA 205 North East Avenue, Anesthesia Department, Jackson, MI 49201 Ph: (517) 205-4963

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Jackson, MI

Joshua Booth, CRNA Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800
Mr. Steven John Dickerson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6700 S Jackson Rd, Jackson, MI 49201 Phone: 517-789-5481 Fax: 517-782-7926
Mr. Michael Paul Haas, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4963
Rocco Mascioli, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 744 W Michigan Ave, Jackson, MI 49201 Phone: 517-787-6440 Fax: 517-787-4146
Meredith Meston, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4963
Kara E. Bono, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 255 W Michigan Ave, Jackson, MI 49201 Phone: 800-516-5315 Fax: 517-787-7365
Gavin Nathan Baker, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 255 W Michigan Ave, Jackson, MI 49201 Phone: 800-516-5315 Fax: 517-787-7365

Mrs Nicole Antonia Moreno, CRNA - Medicare Nurse Anesthetist, Certified Registered in Jackson, MI