Individual provider Active NPI

Thomas M Cacciapalle, CRNA

  • Certified Registered Nurse Anesthetist
  • Kalamazoo, MI
National Provider Identifier
1205120003
Registry record updated Jan 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704245291 Issued in MI
Practice address
900 Peeler St
Kalamazoo, MI 49008-2300
Phone
(269) 345-8618
Fax
(269) 345-1508
NPI assigned
Jun 9, 2011
Last updated
Jan 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2017

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 4704245291 MI Primary

Addresses

Primary practice location

900 Peeler St
Kalamazoo, MI 49008-2300

Mailing address

900 Peeler St
Kalamazoo, MI 49008-2300
Phone (269) 345-8618

Other identifiers 1

IdentifierTypeStateIssuer
4704245291OtherMIMI LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171004001960 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9436320157 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sentry Anesthesia Management, LLCGroup PAC ID 9436372323, 170 clinicians

Practice addresses (Care Compare)

126 US Hwy 280 W
Americus, GA 31719-8645
Phone (229) 924-6011

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704245291MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Anesthesia Management, LLC CurrentSince Sep 1, 2022 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Jun 1, 2017 Accepting new patients
Gastro South Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2023 Accepting new patients
North Tampa Anesthesia Consultants Past Accepting new patients

Locations

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

249 Sheraton Blvd
Macon, GA 31210
Phone (478) 241-2780

777 Hemlock St
Macon, GA 31201
Phone (478) 474-5600

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484784000000",
    "number": "1205120003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PEELER ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490082300",
            "telephone_number": "269-345-8618",
            "fax_number": "269-345-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACCIAPALLE",
        "first_name": "THOMAS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2017-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704245291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI LICENSE",
            "identifier": "4704245291",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.