Individual provider Active NPI

Nicole L Brumage, CRNA

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1124490594
Registry record updated Mar 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209013912 Issued in IL
Practice address
1959 NE Pacific St
Seattle, WA 98195-8132
Phone
(206) 520-5700
NPI assigned
Oct 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 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 041.435683 IL
Certified Registered Nurse Anesthetist 367500000X 209013912 IL Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-8132

Mailing address

500 W Superior St
Unit 2009
Chicago, IL 60654-8132
Phone (724) 544-8284

Other practice location 1

500 W Superior St
Unit 2009
Chicago, IL 60654-8132
Phone (724) 544-8284

Other identifiers 1

IdentifierTypeStateIssuer
1124490594MedicaidWA

Other names 1

  • Nicole L Snyder Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190502002502 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810293495 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

Hospital & facility affiliations

  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.435683ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
The Association of University Physicians CurrentSince Feb 7, 2019 Accepting new patients

Locations

21600 Highway 99
Ste 260
Edmonds, WA 98026
Phone (425) 774-2650

11800 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-4500

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

501 N 34th St
Ste 101
Seattle, WA 98103
Phone (206) 838-1777

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 and National Provider Directory roles.

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1124490594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SUPERIOR ST",
            "address_2": "UNIT 2009",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606548132",
            "telephone_number": "724-544-8284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981958132",
            "telephone_number": "206-520-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Superior St",
            "address_2": "Unit 2009",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606548132",
            "country_code": "US",
            "telephone_number": "724-544-8284",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUMAGE",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.435683",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209013912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124490594",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "SNYDER",
            "middle_name": "L",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.