Individual provider Active NPI

Anthony Cienfuegos, CRNA

  • Certified Registered Nurse Anesthetist
  • Normal, IL
National Provider Identifier
1073027462
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209016895 Issued in IL
Practice address
1302 Franklin Ave
Normal, IL 61761-3551
Phone
(309) 268-5867
NPI assigned
Nov 22, 2017
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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 209016895 IL Primary

Addresses

Primary practice location

1302 Franklin Ave
Normal, IL 61761-3551

Mailing address

611 W Park St
Fapc
Urbana, IL 61801

Other practice location 1

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211000331 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466710967 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Midwestern University College of Dental Medicine, Glendale, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209016895ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Bromenn Medical Center CurrentSince Oct 30, 2023 Accepting new patients
Carle Health Medical Group CurrentSince Oct 4, 2025 Accepting new patients
Carle West Physician Group Inc CurrentSince Oct 30, 2023 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Feb 1, 2026 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Feb 1, 2026 Accepting new patients
Carle Bromenn Medical Center CurrentSince Oct 30, 2023 Accepting new patients
Carle Eureka Hospital Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503

1302 Franklin Ave
Normal, IL 61761
Phone (309) 268-5867

1304 Franklin Ave
Normal, IL 61761
Phone (309) 268-3590

800 E Locust St
Olney, IL 62450
Phone (618) 395-2131

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 7

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": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1073027462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-268-5867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623012834",
            "country_code": "US",
            "telephone_number": "217-223-8400",
            "fax_number": "217-223-9945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIENFUEGOS",
        "first_name": "ANTHONY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209016895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.