WADE KYLE MOORE – Certified Registered Nurse Anesthetist, NPI 1053107672

WADE KYLE MOORE is a healthcare provider. based in Hutchinson, Kansas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 43-558280-122 (KS). The NPI Number for WADE KYLE MOORE is 1053107672

Main info

Male
Sole Proprietor
1 Year Of Experience
Accepts Medicare Assignment
Name
WADE KYLE MOORE
NPI
1053107672
Phone
(620) 245-4715
Address
5 MONARCH LN
Enumeration Date
18 April 2025
Last Update Date
28 May 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6206626000
Graduation Year
2025 (1 year ago)
PAC ID
1759892870
Group Practice PAC ID
7113374737
Professional Enrollment ID
I20250616003319
Address ID
KS675021106HU1818XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

966 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in KS

Provider Addresses for WADE KYLE MOORE

  • 5 MONARCH LN

    HUTCHINSON, KS 675029115

    Phone: (620) 245-4715

    Type: Mailing

  • 1701 E 23RD AVE

    HUTCHINSON, KS 675029907

    Phone: (620) 524-0799

    Type: Location

  • 1818 E 23rd Ave

    Hutchinson, KS 675021106

    Phone: (620) 663-4800

    Type: Location

  • 2101 N Waldron St Bldg 2205

    Hutchinson, KS 675021197

    Phone: (620) 728-2700

    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: 2025-06-16

PECOS data refreshed: 2026-05-27

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
I20250616003319ICertified Registered Nurse Anesthetist (Crna)KSTBD

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 67502)

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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: 7113374737View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS
Certified Registered Nurse Anesthetist (Crna)KS

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Frequently asked questions

Can I verify WADE KYLE MOORE with an NPI only?
You can start verification with NPI 1053107672 for WADE KYLE MOORE, then check state licensing separately.
Is WADE KYLE MOORE still practicing?
WADE KYLE MOORE is currently listed as active in the public NPI registry.
What is WADE KYLE MOORE's primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for WADE KYLE MOORE here. Clinical services aligned with this taxonomy classification.
What address line appears for WADE KYLE MOORE?
WADE KYLE MOORE's geographic hint is Hutchinson, Kansas in our summary view.
Is the information about WADE KYLE MOORE up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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