Individual provider Active NPI

David A Brentz, CRNA

  • Certified Registered Nurse Anesthetist
  • Lucedale, MS
National Provider Identifier
1033476288
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R889843 Issued in MS
Practice address
859 Winter St
Lucedale, MS 39452-6603
Phone
(601) 947-3161
Fax
(601) 947-9206
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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 R889843 MS Primary

Addresses

Primary practice location

859 Winter St
Lucedale, MS 39452-6603

Mailing address

PO Box 607
Lucedale, MS 39452-0607
Phone (601) 947-3161

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190716003701 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436459252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Atlanta School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

2901 B Swann Ave
Tampa, FL 33609-4056
Phone (813) 873-6400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R889843MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 15, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Apr 15, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Nov 4, 2021 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

516 Vonderburg Dr
Brandon, FL 33511
Phone (813) 654-7771

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

11375 Cortez Blvd
#50
Spring Hill, FL 34613
Phone (352) 592-2753

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

2901 W Swann Ave
Tampa, FL 33609
Phone (813) 783-6400

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-0793

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334188800000",
    "number": "1033476288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394520607",
            "telephone_number": "601-947-3161",
            "fax_number": "601-947-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WINTER ST",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526603",
            "telephone_number": "601-947-3161",
            "fax_number": "601-947-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENTZ",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "R889843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.