Individual provider Active NPI

David Imperatore

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1144654021
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN616965 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(706) 650-0705
NPI assigned
Aug 27, 2013
Last updated
Aug 27, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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 RN616965 PA Primary
Certified Registered Nurse Anesthetist 367500000X 26NO11347600 NJ

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Philadelphia, PA 19107-6130
Phone (706) 650-0705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131101001206 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577798347 Reassigns benefits to 1 organization
I20141014000624 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3577798347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Society Hill Anesthesia Consultants of New Jersey, PCGroup PAC ID 9133150063, 18 clinicians
Society Hill Anesthesia Consultants PCGroup PAC ID 5991617292, 210 clinicians

Practice addresses (Care Compare)

408 Route 70 E
Wills Eye Surgery Center in Cherry
Cherry Hill, NJ 08034
Phone (856) 354-1600

800 Spruce St
Philadelphia, PA 19107-6130
Phone (215) 829-5664

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
26NO11347600NJMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Society Hill Anesthesia Consultants of New Jersey, PC CurrentSince Aug 5, 2014 Accepting new patients
Society Hill Anesthesia Consultants, PC CurrentSince Sep 3, 2013 Accepting new patients
Pennsylvania Hospital Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

408 Route 70 E
Cherry Hill, NJ 08034
Phone (267) 322-7700

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

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.

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": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1144654021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "706-650-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "706-650-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERATORE",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-27",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN616965",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NO11347600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.