Individual provider Active NPI

Susan M Milbach, CRNA

  • Certified Registered Nurse Anesthetist
  • Federal Way, WA
National Provider Identifier
1235133067
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP60089224 Issued in WA
Practice address
34503 9TH Ave S
Suite 240
Federal Way, WA 98003-8727
Phone
(253) 838-9839
Fax
(253) 661-9077
NPI assigned
Jun 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP60089224 WA Primary
Certified Registered Nurse Anesthetist 367500000X 0024164185 VA

Addresses

Primary practice location

34503 9TH Ave S
Suite 240
Federal Way, WA 98003-8727

Mailing address

2420 S Union Ave Ste 200
Tacoma, WA 98405-1323
Phone (253) 503-2598

Other identifiers 3

IdentifierTypeStateIssuer
G8885531OtherWAPTAN (N)
G8885532OtherWAPTAN (S)
008933448MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024164185VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Anesthesia Associates, P.C. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1235133067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 S UNION AVE STE 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051323",
            "telephone_number": "253-503-2598",
            "fax_number": "253-682-2427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE S",
            "address_2": "SUITE 240",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038727",
            "telephone_number": "253-838-9839",
            "fax_number": "253-661-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBACH",
        "first_name": "SUSAN",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-09",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60089224",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024164185",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN (N)",
            "identifier": "G8885531",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN (S)",
            "identifier": "G8885532",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008933448",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.