Individual provider Active NPI

Michael Ford, CRNA

  • Certified Registered Nurse Anesthetist
  • Darby, PA
National Provider Identifier
1003850546
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN504510L Issued in PA
Practice address
1500 Lansdowne Ave
Darby, PA 19023-1200
Phone
(610) 237-4500
Fax
(856) 423-0823
NPI assigned
Jun 15, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN504510L PA Primary

Addresses

Primary practice location

1500 Lansdowne Ave
Darby, PA 19023-1200

Mailing address

PO Box 820137
Philadelphia, PA 19182-0137
Phone (610) 270-2717

Other identifiers 2

IdentifierTypeStateIssuer
001867376MedicaidPA
P00365592OtherRAILROAD MEDICARE PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000093 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183629017 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Current Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 9, 2010 Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 9, 2010 Accepting new patients
Mercy Management of SE PA Nurse Anesthetist, Certified Registered Past Accepting new patients
SCHC Pediatric Anesthesia Associates, LLC Past Accepting new patients
Premier Anesthesia of Pennsylvania PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

3551 N Broad St
Philadelphia, PA 19140
Phone (215) 430-4000

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1003850546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820137",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820137",
            "telephone_number": "610-270-2717",
            "fax_number": "610-270-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LANSDOWNE AVE",
            "city": "DARBY",
            "state": "PA",
            "postal_code": "190231200",
            "telephone_number": "610-237-4500",
            "fax_number": "856-423-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN504510L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001867376",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00365592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Darby, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.