Active NPI
Nafees Fazal, CRNA
- Certified Registered Nurse Anesthetist
- Youngstown, OH
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- RN311835
- Practice address
- 1044 Belmont Ave
Youngstown, OH 44504-1006 - Phone
- (330) 480-3658
- Fax
- (330) 480-3439
- NPI assigned
- Jan 30, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN311835 | OH | Primary |
Addresses
Primary practice location
1044 Belmont Ave
Youngstown, OH 44504-1006
Mailing address
4135 Boardman Canfield Rd
Suite 101
Canfield, OH 44406-9803
Phone (330) 286-5330
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12519024 | Other | CAQH | |
| P01188864 | Other | OH | MEDICARE RAILROAD |
| H167270 | Other | OH | MEDICARE PTAN |
| 000000802991 | Other | OH | ANTHEM BCBS |
| 0079213 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1044 Belmont Ave
Youngstown, OH 44504-1006
Phone (330) 480-3658
Hospital & facility affiliations
- HMHP St Elizabeth Boardman Health Center
- MH St Joseph Warren Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN311835 | OH | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Erie Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Bel-Park Anesthesia Associates, Inc. | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
4135 Boardman Canfield Rd
Ste 101
Canfield, OH 44406
Phone (330) 532-7215
8185 Washington St
Ste 6
Chagrin Falls, OH 44023
Phone (440) 708-0582
1611 S Green Rd
Ste 120
South Euclid, OH 44121
Phone (440) 708-0582
1044 Belmont Ave
Youngstown, OH 44504
Phone (330) 480-2182
8401 Market St
Youngstown, OH 44512
Phone (330) 729-2929
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Youngstown, OH
- NPI 1508813528
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Chagrin Falls, OH
- NPI 1265927594
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Warren, OH
- NPI 1629009964
-
- General Acute Care Hospital
- Youngstown, OH
- NPI 1790868982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1134467871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 BOARDMAN CANFIELD RD",
"address_2": "SUITE 101",
"city": "CANFIELD",
"state": "OH",
"postal_code": "444069803",
"telephone_number": "330-286-5330",
"fax_number": "330-286-5396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1044 BELMONT AVE",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "445041006",
"telephone_number": "330-480-3658",
"fax_number": "330-480-3439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAZAL",
"first_name": "NAFEES",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-30",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OH",
"license": "RN311835",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "12519024",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P01188864",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "H167270",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000802991",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0079213",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.