Individual provider Active NPI

Eric M Coppala, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
National Provider Identifier
1215041405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9216799 Issued in FL
Practice address
1304 Oak St
Melbourne, FL 32901-3111
Phone
(321) 723-4723
Fax
(321) 727-1448
NPI assigned
Aug 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ARNP9216799 FL Primary

Addresses

Primary practice location

1304 Oak St
Melbourne, FL 32901-3111

Mailing address

1304 Oak St
Melbourne, FL 32901-3111
Phone (321) 723-4723

Other identifiers 2

IdentifierTypeStateIssuer
P00216595OtherFLRRMCR
G3645OtherFLBCBSFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050216000521 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 8527010750 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amsurg Rockledge FL Anesthesia, LLCGroup PAC ID 1456597871, 6 clinicians
Physician Partners of America Crna Operations LLCGroup PAC ID 8022239722, 44 clinicians
Florida Pain Relief Group PLLCGroup PAC ID 4688960271, 80 clinicians

Practice addresses (Care Compare)

1974 Rockledge Blvd
Suite 102
Rockledge, FL 32955-3756
Phone (321) 504-4440

450 E Merritt Island Cswy
Suite 400
Merritt Island, FL 32952-3503
Phone (321) 735-6221

4730 N Habana Ave
Suite 104
Tampa, FL 33614-7165
Phone (813) 739-7498

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Amsurg Rockledge FL Anesthesia LLC CurrentSince Jul 20, 2020 Accepting new patients
Florida Pain Relief Group PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2023 Accepting new patients
Brevard Physician Associates, PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2013 Accepting new patients
Physician Partners of America Crna Operations LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 5, 2020 Accepting new patients
Anesthesia Professional Services of Brevard LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
The Stingl Family Foundation, Inc PastSince May 7, 2016 Accepting new patients

Locations

10301 Hagen Ranch Rd
Ste B270
Boynton Beach, FL 33437
Phone (561) 853-1001

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

520 E Strawbridge Ave
Melbourne, FL 32901

450 E Merritt Island Cswy
Ste 400
Merritt Island, FL 32952
Phone (321) 735-6221

1974 US Highway 1
Ste 102
Rockledge, FL 32955
Phone (321) 504-4440

3450 E Fletcher Ave
Ste 350
Tampa, FL 33613
Phone (813) 739-7493

4730 N Habana Ave
Ste 104
Tampa, FL 33614
Phone (813) 426-8260

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215041405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 OAK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013111",
            "telephone_number": "321-723-4723",
            "fax_number": "321-727-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 OAK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013111",
            "telephone_number": "321-723-4723",
            "fax_number": "321-727-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPALA",
        "first_name": "ERIC",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9216799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCR",
            "identifier": "P00216595",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "G3645",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.