JAKE R MOSS (CRNA) – Certified Registered Nurse Anesthetist, NPI 1750062022

JAKE R MOSS (CRNA) is a healthcare provider. based in Studio city, California. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 95133238 (CA). The NPI Number for JAKE R MOSS (CRNA) is 1750062022

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
JAKE R MOSS (CRNA)
NPI
1750062022
Phone
Not provided
Address
12858 WOODBRIDGE ST
Enumeration Date
28 July 2023
Last Update Date
3 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8059882500
Graduation Year
2024 (2 years ago)
PAC ID
6901334275
Group Practice PAC ID
6406049592
Professional Enrollment ID
I20250114003160
Address ID
CA930303722OX1600XAVEX400

Contacts

SOAP Endpoint
https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:2State licenses:2Other namesUpdated within 12 months

2,470 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in CA

Provider Addresses for JAKE R MOSS (CRNA)

  • 12858 WOODBRIDGE ST

    STUDIO CITY, CA 916041560

    Phone:

    Type: Mailing

  • 1600 N ROSE AVE

    OXNARD, CA 930303722

    Phone: (805) 988-2500

    Type: Location

  • 12858 Woodbridge St

    Studio City, CA 916041560

    Phone: (661) 433-4209

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-01-14

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250114003160ICertified Registered Nurse Anesthetist (Crna)CATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406049592View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YCA
-CA
A N E S T H E S I O L O G YCA
-CA
Certified Registered Nurse Anesthetist (Crna)CA
A N E S T H E S I O L O G YCA
-CA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA
A N E S T H E S I O L O G YCA

Reviews

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Frequently asked questions

Where can patients find JAKE R MOSS (CRNA)'s NPI?
You can confirm JAKE R MOSS (CRNA) with NPI 1750062022; it appears in the national provider directory.
Is JAKE R MOSS (CRNA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is JAKE R MOSS (CRNA)?
The page reflects Certified Registered Nurse Anesthetist for JAKE R MOSS (CRNA). Clinical services aligned with this taxonomy classification.
Where does public data place JAKE R MOSS (CRNA)?
The snapshot lists Studio City, California for JAKE R MOSS (CRNA); download NPPES for the complete set.
What if Studio City, California seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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