Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Moore

Individual provider Certified Registered Nurse Anesthetist · NPI 1154000438

Samuel Moore is a Certified Registered Nurse Anesthetist (CRNA) in Minneapolis, Minnesota. Qualified in 2016, 10 years ago. Practices with University Anesthesia Providers LLC, a 332-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
10
Licensed in
MN
In the registry since
2023
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Practice location Address checks out

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone: (612) 273-8383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 2893 (MN)

Record details

NPI number1154000438
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 14, 2023
Last updated in NPPESOctober 10, 2023
Certification dateOctober 10, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice University Anesthesia Providers Llc — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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