Individual provider Active NPI

Daniel Fortich, DNP, CRNA, APRN

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1033710082
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11011099 Issued in FL
Practice address
11750 SW 40TH St
Miami, FL 33175-3530
Phone
(305) 223-3000
NPI assigned
Nov 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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 11011099 FL Primary

Addresses

Primary practice location

11750 SW 40TH St
Miami, FL 33175-3530

Mailing address

10315 SW 130TH CT
Miami, FL 33186-2361
Phone (786) 395-3231

Other practice location 1

10315 SW 130th Ct
Miami, FL 33186-2361
Phone (786) 395-3231

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210304002720 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1456767029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians
Anesthesia Physician Solutions of South Florida, LLCGroup PAC ID 4688805286, 238 clinicians

Practice addresses (Care Compare)

1 Tampa General Cir
Tampa, FL 33606-3571
Phone (813) 844-4396

11750 SW 40 St
Miami, FL 33175-3530
Phone (954) 939-5000

Hospital & facility affiliations

  • Tampa General Hospital Hospital, Tampa, FL, CCN 100128
  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11011099FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 19, 2024 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Feb 19, 2024 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2021 Accepting new patients

Locations

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

3663 S Miami Ave
Miami, FL 33133
Phone (305) 285-2131

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1033710082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 SW 130TH CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331862361",
            "telephone_number": "786-395-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 SW 40TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753530",
            "telephone_number": "305-223-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10315 SW 130th Ct",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331862361",
            "country_code": "US",
            "telephone_number": "786-395-3231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORTICH",
        "first_name": "DANIEL",
        "credential": "DNP, CRNA, APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-05",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11011099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.