Individual provider Active NPI

Charles Gresko-McTiernan, CRNA

  • Certified Registered Nurse Anesthetist
  • Orlando, FL
National Provider Identifier
1205415320
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11026479 Issued in FL
Practice address
3435 Pinehurst Ave
Orlando, FL 32804-4049
Phone
(407) 801-3888
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 9463014 FL
Certified Registered Nurse Anesthetist 367500000X 11026479 FL Primary

Addresses

Primary practice location

3435 Pinehurst Ave
Orlando, FL 32804-4049

Mailing address

671 Gamewell Ave
Maitland, FL 32751-4401
Phone (850) 556-3278

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230911000476 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315301355 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
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)

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 764-4000

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
9463014FLMDRegistered Nurse
11026479FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Jul 28, 2023 Accepting new patients
Innovative Medical Staffing Solutions Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 16, 2023 Accepting new patients
Fleming Island Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 10, 2023 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

4571 Colonial Blvd
Ste 200
Fort Myers, FL 33966
Phone (239) 333-2050

63 Barkley Cir
Ste 103
Fort Myers, FL 33907
Phone (239) 275-8882

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

400 Celebration Pl
Kissimmee, FL 34747
Phone (407) 303-4000

905 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 256-0933

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

110 N Lecanto Hwy
Lecanto, FL 34461
Phone (352) 527-1825

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

9035 Sunset Dr
Ste 200
Miami, FL 33173
Phone (786) 615-6210

130 Tamiami Trl N
Ste 210
Naples, FL 34102
Phone (239) 434-8707

1670 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 541-3048

100 S Orange Ave
Ste 800
Orlando, FL 32801
Phone (407) 377-0251

100 N Dean Rd
Ste 102
Orlando, FL 32825
Phone (407) 506-0006

3435 Pinehurst Ave
Orlando, FL 32804
Phone (321) 841-8199

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

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

483 N Semoran Blvd
Winter Park, FL 32792
Phone (407) 367-0742

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1205415320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 GAMEWELL AVE",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514401",
            "telephone_number": "850-556-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 PINEHURST AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044049",
            "telephone_number": "407-801-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESKO-MCTIERNAN",
        "first_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9463014",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11026479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.