Individual provider Active NPI

Damien Joseph Rostorfer, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1154626901
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9180005 Issued in FL
Practice address
655 W 8TH St
Ufjax - Dept. of Anesthesiology
Jacksonville, FL 32209-6511
Phone
(904) 244-4195
Fax
(904) 244-4908
NPI assigned
Jan 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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 ARNP9180005 FL Primary

Addresses

Primary practice location

655 W 8TH St
Ufjax - Dept. of Anesthesiology
Jacksonville, FL 32209-6511

Mailing address

PO Box 44008
Ufjp - Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3199

Other identifiers 2

IdentifierTypeStateIssuer
003105279AMedicaidGA
0031378-00MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160425001863 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870776446 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City Hospital IncGroup PAC ID 3375444524, 155 clinicians

Practice addresses (Care Compare)

2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 260-1443

Hospital & facility affiliations

  • Berkeley Medical Center Hospital, Martinsburg, WV, CCN 510008

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Memorial Hospital CurrentSince Sep 23, 2018 Accepting new patients
Jefferson Memorial Hospital CurrentSince Sep 23, 2018 Accepting new patients
City Hospital, Inc. CurrentSince Apr 4, 2016 Accepting new patients
Jefferson Memorial Hospital Current Accepting new patients
City Hospital Inc Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

300 S Preston St
Ranson, WV 25438
Phone (304) 728-1600

Organizations & group practices 5

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": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301529600000",
    "number": "1154626901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP - PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008",
            "telephone_number": "904-244-3199",
            "fax_number": "904-244-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJAX - DEPT. OF ANESTHESIOLOGY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4195",
            "fax_number": "904-244-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSTORFER",
        "first_name": "DAMIEN",
        "middle_name": "JOSEPH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9180005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003105279A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0031378-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.