NPIMap

Individual provider Active NPI

Michael T Reid, CRNA

  • Certified Registered Nurse Anesthetist
  • Colton, CA
National Provider Identifier
1104832039
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA2132 Issued in CA
Practice address
900 E Washington St
Ste. 100
Colton, CA 92324-7111
Phone
(909) 370-2190
NPI assigned
Jul 31, 2006
Last updated
Jul 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NA 2132 CA
Certified Registered Nurse Anesthetist 367500000X NA2132 CA Primary

Addresses

Primary practice location

900 E Washington St
Ste. 100
Colton, CA 92324-7111

Mailing address

PO Box 1448
Rancho Cucamonga, CA 91729-1448
Phone (909) 946-5752

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707001086 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3375589617 Receives reassigned benefits from 13 practitioners
Practice locations: Arcadia, CA; Colton, CA; Murrieta, CA; Riverside, CA; San Bernardino, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NA 2132CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Reid Crna Nurse Anesthetist, Certified Registered PastSince Jul 1, 2023 Accepting new patients
Glendale Ophthalmology ASC LP Past Accepting new patients

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1104832039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1448",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917291448",
            "telephone_number": "909-946-5752",
            "fax_number": "909-985-3858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E WASHINGTON ST",
            "address_2": "STE. 100",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923247111",
            "telephone_number": "909-370-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA 2132",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA2132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.