Dennis Dan Carballo Sy, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95000333 Issued in CA

Practice address

726 4TH St
Marysville, CA 95901-5656

Phone

(530) 751-4295

NPI assigned

Jan 4, 2012

Last updated

Feb 24, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Services of San Joaquin PCGroup PAC ID 4082754056, 75 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.7 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations (25 of 28)

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9170/brand/1/csg/1/fhir/r4

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.

• Anesthesia Services of San Joaquin, P.C.

  • Anesthesiology Physician
  • French Camp, CA
  • NPI 1366778227
  Medicare reassignment Care Compare group NPD
• Palm Springs Anesthesia Services, PC

  • Anesthesiology Physician
  • San Bernardino, CA
  • NPI 1083928501
  Medicare reassignment NPD
• United Medical Doctors

  • Gastroenterology Physician
  • Murrieta, CA
  • NPI 1770559981

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415
  Medicare reassignment NPD
• Rideout Memorial Hospital

  dba Adventist Health and Rideout

  • General Acute Care Hospital
  • Marysville, CA
  • NPI 1720088354
  NPD
• United Medical Doctors

  • Orthopaedic Surgery Physician
  • San Diego, CA
  • NPI 1194554675
  NPD

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1023388378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 4TH ST",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "959015656",
            "telephone_number": "530-751-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SY",
        "first_name": "DENNIS DAN",
        "middle_name": "CARBALLO",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "808011",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295076801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8801UC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01095297",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2338056",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "295076802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sutter North Medical Foundation
• Sutter Valley Medical Foundation (Sutter North Medical Foundation)
• Sutter-Butte Anesthesia Associates
• Amanda Sutton
• Harjot Swan
• Amzie P Tafua
• Jenine Lucille Tanabe, M.D.
• Nathan H Tang, M.D.
• Allison Taylor, SLP
• Richard Thomas Taylor

• Certified Registered Nurse Anesthetist in Marysville, CA
• Providers in Marysville, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.