Individual provider Active NPI

Odelkys Alvarez

  • Certified Registered Nurse Anesthetist
  • Portsmouth, VA
National Provider Identifier
1033651633
Registry record updated May 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024174615 Issued in VA
Practice address
3636 High St
Portsmouth, VA 23707-3236
Phone
(757) 398-2200
NPI assigned
Nov 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0001268610 VA
Certified Registered Nurse Anesthetist 367500000X 0024174615 VA Primary

Addresses

Primary practice location

3636 High St
Portsmouth, VA 23707-3236

Mailing address

3017 Gateway Dr Apt 201
Suffolk, VA 23435-1146
Phone (305) 772-5256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170615002093 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698043693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1602 Skipwith Rd
Henrico, VA 23229-5205
Phone (804) 289-4500

19455 Deerfield Ave
Suite 204
Leesburg, VA 20176-8102
Phone (703) 724-9950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0001268610VAMDRegistered Nurse
0024174615VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jun 1, 2021 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jun 1, 2021 Accepting new patients

Locations

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

2750 Godwin Blvd
Suffolk, VA 23434
Phone (757) 983-2000

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558742400000",
    "number": "1033651633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 GATEWAY DR APT 201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351146",
            "telephone_number": "305-772-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 HIGH ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073236",
            "telephone_number": "757-398-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "ODELKYS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-14",
        "last_updated": "2019-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "VA",
            "license": "0001268610",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024174615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2019; 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.