Individual provider Active NPI

Kevin F Bohac, CRNA

  • Certified Registered Nurse Anesthetist
  • Carroll, IA
National Provider Identifier
1104806223
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
088828 Issued in IA
Practice address
311 S Clark Street
Carroll, IA 51401-3038
Phone
(712) 792-3581
Fax
(712) 792-2124
NPI assigned
Jan 17, 2006
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

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 088828 IA Primary

Addresses

Primary practice location

311 S Clark Street
Carroll, IA 51401-3038

Mailing address

PO Box 628
Carroll, IA 51401-0628
Phone (712) 792-3581

Other identifiers 1

IdentifierTypeStateIssuer
1188706MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070412000409 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537264908 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cass County Memorial HospitalGroup PAC ID 5294634994, shared by 9 NPIs, 67 clinicians

Practice addresses (Care Compare)

1501 E 10TH St
Atlantic, IA 50022-1936
Phone (712) 243-3250

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
67.8 of 100Reported as group
Quality
85.99
Promoting interoperability
96
Improvement activities
40
Cost
10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
088828IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cass County Memorial Hospital CurrentSince Aug 1, 2022 Accepting new patients
Trinity Regional Medical Center Nurse Anesthetist, Certified Registered CurrentSince Sep 7, 2022 Accepting new patients
Cass County Memorial Hospital Current Accepting new patients
Cass County Memorial Hospital CurrentSince Aug 1, 2022 Accepting new patients
Geary Anesthesia Associates PA Nurse Anesthetist, Certified Registered PastSince Sep 8, 2008 Accepting new patients
Hastings Anesthesiology Associates PC PastSince Jan 21, 2004 Accepting new patients

Locations

1501 E 10th St
Atlantic, IA 50022
Phone (712) 243-2850

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Organizations & group practices 6

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": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1104806223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 628",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010628",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S CLARK STREET",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514013038",
            "telephone_number": "712-792-3581",
            "fax_number": "712-792-2124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAC",
        "first_name": "KEVIN",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "088828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1188706",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.