Individual provider Active NPI

Samantha Stophel Farmand, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1164967337
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9344882 Issued in FL
Practice address
1 Shircliff Way
Jacksonville, FL 32204-4748
Phone
(904) 387-4030
NPI assigned
Dec 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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 9344882 FL Primary

Addresses

Primary practice location

1 Shircliff Way
Jacksonville, FL 32204-4748

Mailing address

1 Shircliff Way
Jacksonville, FL 32204-4748

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address samantha.stophel@envisionhealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170828001654 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6608148556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

10475 Centurion Pkwy N
Suite 101
Jacksonville, FL 32256-5004
Phone (904) 652-2328

Hospital & facility affiliations

  • Ascension St Vincent'S Southside Hospital, Jacksonville, FL, CCN 100307

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9344882FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Anesthesia Consultants Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 22, 2017 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2023 Accepting new patients
North Florida Anesthesia Consultants, Inc. CurrentSince Feb 22, 2017 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

10475 Centurion Pkwy N
Ste 101
Jacksonville, FL 32256
Phone (904) 652-2328

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

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": "1482796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1164967337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHIRCLIFF WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044748",
            "telephone_number": "904-387-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMAND",
        "first_name": "SAMANTHA",
        "middle_name": "STOPHEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-27",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9344882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "samantha.stophel@envisionhealth.com",
            "affiliation": "N",
            "address_1": "1 Shircliff Way",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322044748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 10, 2022; 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.