Vincent F Polvinale, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN096241 Issued in GA

Practice address

4575 North Shallowford Road
Dunwoody, GA 30338

Phone

(770) 454-4286

Fax

(770) 454-4065

NPI assigned

May 24, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Centurion Anesthesia - FL LLCGroup PAC ID 6103205620, 106 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Centurion Anesthesia - FL LLC

  • Anesthesiology Physician
  • Hollywood, FL
  • NPI 1700528346
  Medicare reassignment Care Compare group NPD
• Moonlight Anesthesia, P.L.

  • Anesthesiology Physician
  • Fort Myers, FL
  • NPI 1033419791
  Medicare reassignment NPD
• Quantum Anesthesia Services PA

  • Anesthesiology Physician
  • Key West, FL
  • NPI 1306270806
  Medicare reassignment NPD

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357257600000",
    "number": "1154376341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70128",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300070128",
            "telephone_number": "770-578-1800",
            "fax_number": "770-578-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 NORTH SHALLOWFORD ROAD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "770-454-4286",
            "fax_number": "770-454-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLVINALE",
        "first_name": "VINCENT",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN096241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000550624C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eliana Cristina Pimentel, PSYD
• Lee Woodrow Plunkett, DMD
• Nicole Pokalsky
• Carrie Rachel Poline, D.O.
• Octavia Davis Pollard, CSFA
• Michele Lynn Pond, PT
• Alicia Allison Porter, LPC
• Mary Madison Porter, PT, DPT
• Richard Austin Posey, DPT
• Amber S Powell

• Certified Registered Nurse Anesthetist in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.