Individual provider Active NPI

Justin M Sauder, CRNA

  • Certified Registered Nurse Anesthetist
  • Wauseon, OH
National Provider Identifier
1194223347
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019607 Issued in OH
Practice address
725 S Shoop Ave
Wauseon, OH 43567-1702
Phone
(419) 335-2015
NPI assigned
Jan 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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 APRN.CRNA.019607 OH Primary

Addresses

Primary practice location

725 S Shoop Ave
Wauseon, OH 43567-1702

Mailing address

313 Madison St
Wauseon, OH 43567-1123

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180308001820 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254692254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Anesthesia Providers LLCGroup PAC ID 2567682073, 7 clinicians

Practice addresses (Care Compare)

725 S Shoop Ave
Wauseon, OH 43567-1702
Phone (419) 335-2015

7500 State Rd
Cincinnati, OH 45255-2439
Phone (513) 624-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.019607OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Anesthesia & Intensive Care Consultants,Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Northern Anesthesia Providers, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2018 Accepting new patients

Locations

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

L3856
Columbus, OH 43260

725 S Shoop Ave
Wauseon, OH 43567
Phone (419) 335-2015

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": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1194223347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 MADISON ST",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671702",
            "telephone_number": "419-335-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUDER",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; 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.