Individual provider Active NPI

Mehran Jafari Khosravi, CRNA

  • Certified Registered Nurse Anesthetist
  • Spokane, WA
National Provider Identifier
1164491007
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
47081 Issued in WA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-4971
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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 47081 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

4416 E 42ND Ave
Spokane, WA 99223-1229
Phone (509) 443-6762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060221000002 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951316413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Service- WashingtonGroup PAC ID 0840279758, 170 clinicians

Practice addresses (Care Compare)

101 W 8TH Ave
Spokane, WA 99204-2307
Phone (509) 474-3131

Hospital & facility affiliations

  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
83.21
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47081WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Service- Washington CurrentSince Jan 1, 2013 Accepting new patients
Empire Health Services Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

101 W 8th Ave
Spokane, WA 99204
Phone (509) 474-3181

101 W 8th Ave
Fl 3
Spokane, WA 99204
Phone (509) 474-2277

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 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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1164491007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4416 E 42ND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992231229",
            "telephone_number": "509-443-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVI",
        "first_name": "MEHRAN",
        "middle_name": "JAFARI",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "47081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.