Individual provider Active NPI

Brian Ray Sheufelt, CRNA, MSN

  • Certified Registered Nurse Anesthetist
  • Tacoma, WA
National Provider Identifier
1174694335
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
525154 Issued in CA
Practice address
9040 Jackson Ave
Tacoma, WA 98431-2941
Phone
(253) 968-1110
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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 525154 CA Primary

Addresses

Primary practice location

9040 Jackson Ave
Tacoma, WA 98431-2941

Mailing address

7300 N Fresno St
Fresno, CA 93720-2941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100527000672 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880508233 Reassigns benefits to 2 organizations
I20171129003205 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880508233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Practice addresses (Care Compare)

120 NW 14TH Ave
Suite 200
Portland, OR 97209-2642
Phone (503) 771-1883

8506 E Mill Plain Blvd
Suite C
Vancouver, WA 98664-2021
Phone (360) 823-0883

Hospital & facility affiliations

  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
525154CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 12, 2010 Accepting new patients
Public Hospital District No 2, Klickitat County Washington CurrentSince Jun 2, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Nurse Anesthetist, Certified Registered CurrentSince Mar 12, 2010 Accepting new patients
Anesthesia Associates Northwest LLC CurrentSince Jan 4, 2011 Accepting new patients
Public Hospital District No. 2, Klickitat County, Washington Current Accepting new patients
Public Hospital District No 2, Klickitat County, Washington CurrentSince Jun 2, 2022 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

1900 Woodland Dr
Coos Bay, OR 97420
Phone (541) 267-5151

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

8506 E Mill Plain Blvd
Ste C
Vancouver, WA 98664
Phone (360) 823-0880

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ac6e817f-dc27-43e8-b886-6559f137e853/

Organizations & group practices 6

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1174694335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 N FRESNO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984312941",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEUFELT",
        "first_name": "BRIAN",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "CRNA, MSN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "525154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.