Individual provider Active NPI

Ana Rose Erbeznik, CRNA

  • Certified Registered Nurse Anesthetist
  • Palm Beach Gardens, FL
National Provider Identifier
1215209135
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN9335793 Issued in FL
Practice address
7111 Fairway Drive, Suite 450
Palm Beach Gardens Team Anesthesia, PA
Palm Beach Gardens, FL 33418
Phone
(561) 799-3552
Fax
(561) 799-3527
NPI assigned
Feb 8, 2012
Last updated
Feb 8, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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 RN9335793 FL Primary

Addresses

Primary practice location

7111 Fairway Drive, Suite 450
Palm Beach Gardens Team Anesthesia, PA
Palm Beach Gardens, FL 33418

Mailing address

15245 Chillicothe Rd
P.O. Box 231
Novelty, OH 44072-9656
Phone (440) 796-6832

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120424000552 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668634411 Reassigns benefits to 1 organization

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
PBG Team Anesthesia PAGroup PAC ID 5092856757, 46 clinicians

Practice addresses (Care Compare)

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323
Phone (800) 694-7225

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9335793FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
PBG Team Anesthesia PA Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2012 Accepting new patients

Locations

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Organizations & group practices 1

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": "1328659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1215209135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 CHILLICOTHE RD",
            "address_2": "P.O. BOX 231",
            "city": "NOVELTY",
            "state": "OH",
            "postal_code": "440729656",
            "telephone_number": "440-796-6832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7111 FAIRWAY DRIVE, SUITE 450",
            "address_2": "PALM BEACH GARDENS TEAM ANESTHESIA, PA",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "33418",
            "telephone_number": "561-799-3552",
            "fax_number": "561-799-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERBEZNIK",
        "first_name": "ANA",
        "middle_name": "ROSE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9335793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; 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.