Ethan Aron Moles, DMPNA, CRNA in South Charleston, WV - Medicare Nurse Anesthetist, Certified Registered

Ethan Aron Moles, DMPNA, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in South Charleston, West Virginia. His current practice location is 4605 Maccorkle Ave Sw, South Charleston, West Virginia. You can reach out to his office (for appointments etc.) via phone at (304) 766-3600.

Ethan Aron Moles is licensed to practice in West Virginia (license number 112703) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1578200580.

Contact Information

	Ethan Aron Moles, DMPNA, CRNA
	4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311
	(304) 766-3600
	Not Available

Map and Direction

Provider's Profile

Full Name	Ethan Aron Moles
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	4605 Maccorkle Ave Sw, South Charleston, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1578200580
Provider Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022

Medicare PECOS Information:

PECOS PAC ID: 2860861531
Enrollment ID: I20221220001253

Medical Identifiers

Medical identifiers for Ethan Aron Moles such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1578200580	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	85894 (West Virginia)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	112703 (West Virginia)	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. Ethan Aron Moles allows following entities to bill medicare on his behalf.

Entity Name	Professional Anesthesia Service,inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720035827 PECOS PAC ID: 2769387190 Enrollment ID: O20031126000731

Entity Name	Jefferson Memorial Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891722377 PECOS PAC ID: 0446151989 Enrollment ID: O20040116000736

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. Ethan Aron Moles 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
Ethan Aron Moles, DMPNA, CRNA 1892 Patterson Dr, Elkview, WV 25071-7131 Ph: (304) 941-3630	Ethan Aron Moles, DMPNA, CRNA 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 Ph: (304) 766-3600

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in South Charleston, WV

Lindsey Rubenstein, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600
Bradley S. Persinger, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 80 Rockcrest Dr, South Charleston, WV 25309 Phone: 304-542-3927 Fax: 304-768-2468
Tammy L Cunningham, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600
Jessica Smith, RN Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 Angus E Peyton Dr, South Charleston, WV 25303 Phone: 304-746-2088
Mary E. West, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600
Marnie E. Edwards, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600
Nicholas E. Clark, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4605 Maccorkle Ave Sw, South Charleston, WV 25309 Phone: 304-766-3600

Ethan Aron Moles, DMPNA, CRNA - Medicare Nurse Anesthetist, Certified Registered in South Charleston, WV