Individual provider Active NPI

Jon M Frazier

  • Certified Registered Nurse Anesthetist
  • Wausau, WI
National Provider Identifier
1134472657
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN614643 Issued in PA
Practice address
425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123
Phone
(715) 845-5505
Fax
(715) 848-2884
NPI assigned
Oct 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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 RN614643 PA Primary

Addresses

Primary practice location

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123

Mailing address

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401-4123
Phone (715) 845-5505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130320000099 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 8123263290 Reassigns benefits to 2 organizations

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
Gastrointestinal Associates S.C.Group PAC ID 4385677814, 42 clinicians

Practice addresses (Care Compare)

3225 Business Park Dr
Stevens Point, WI 54482-8837
Phone (715) 847-2558

Merit-based Incentive Payment System (MIPS)

Final score
90.86 of 100Reported as group
Quality
86.95
Promoting interoperability
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN614643PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Wisconsin Anesthesiology CurrentSince Jan 7, 2013 Accepting new patients
Gastrointestinal Associates S.C. CurrentSince Jul 18, 2022 Accepting new patients

Locations

3225 Business Park Dr
Stevens Point, WI 54482
Phone (715) 847-2558

425 Pine Ridge Blvd
Ste 211
Wausau, WI 54401
Phone (715) 845-5505

425 Pine Ridge Blvd
Ste 21
Wausau, WI 54401

411 Westwood Dr
Wausau, WI 54401
Phone (715) 479-0374

333 Pine Ridge Blvd
Wausau, WI 54401
Phone (715) 847-2160

2809 Westhill Dr
Wausau, WI 54401
Phone (715) 842-4490

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.

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1134472657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "STE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 PINE RIDGE BLVD",
            "address_2": "STE 211",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014123",
            "telephone_number": "715-845-5505",
            "fax_number": "715-848-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "JON",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN614643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.