Individual provider Active NPI

Kristopher Bryan Okialda

  • Certified Registered Nurse Anesthetist
  • Sacramento, CA
National Provider Identifier
1225600034
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002274 Issued in CA
Practice address
7500 Hospital Dr
Sacramento, CA 95823-5477
Phone
(510) 935-6500
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 95170173 CA
Certified Registered Nurse Anesthetist 367500000X 95002274 CA Primary

Addresses

Primary practice location

7500 Hospital Dr
Sacramento, CA 95823-5477

Mailing address

10570 Trill Way
Elk Grove, CA 95757-6491
Phone (510) 935-6500

Other practice location 1

10570 Trill Way
Elk Grove, CA 95757-6491
Phone (510) 935-6500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250227000674 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355861808 Reassigns benefits to 1 organization

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
Anesthesia Services of San Joaquin PCGroup PAC ID 4082754056, 75 clinicians

Practice addresses (Care Compare)

7500 Hospital Dr
Sacramento, CA 95823-5403
Phone (916) 423-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95170173CAMDCritical Care Medicine Registered Nurse
95002274CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of San Joaquin, P.C. CurrentSince Jan 1, 2025 Accepting new patients

Locations

8220 Wymark Dr
Elk Grove, CA 95757
Phone (888) 253-1704

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

7500 Hospital Dr
Sacramento, CA 95823
Phone (916) 423-3000

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 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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1225600034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10570 TRILL WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957576491",
            "telephone_number": "510-935-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 HOSPITAL DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235477",
            "telephone_number": "510-935-6500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10570 Trill Way",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957576491",
            "country_code": "US",
            "telephone_number": "510-935-6500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKIALDA",
        "first_name": "KRISTOPHER",
        "middle_name": "BRYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "CA",
            "license": "95170173",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2024; 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.