Individual provider Active NPI

Michael Bozung

  • Certified Registered Nurse Anesthetist
  • Columbia, MO
National Provider Identifier
1245775295
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2016043549 Issued in MO
Practice address
1 S Keene St
Columbia, MO 65201-7199
Phone
(573) 445-7300
Fax
(573) 445-7301
NPI assigned
Dec 29, 2016
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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 2016043549 MO Primary

Addresses

Primary practice location

1 S Keene St
Columbia, MO 65201-7199

Mailing address

PO Box 7536
Columbia, MO 65205-7536
Phone (573) 445-7300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170112001426 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143502849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-America Anesthesia Consultants PCGroup PAC ID 6305837626, 49 clinicians

Practice addresses (Care Compare)

1600 E Broadway
Columbia, MO 65201-5844
Phone (573) 815-5511

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-America Anesthesia Consultants, PC CurrentSince Mar 6, 2021 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1600 E Broadway
Ste 60
Columbia, MO 65201

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 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": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1245775295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7536",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652057536",
            "telephone_number": "573-445-7300",
            "fax_number": "573-445-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S KEENE ST",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017199",
            "telephone_number": "573-445-7300",
            "fax_number": "573-445-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZUNG",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-29",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2016043549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.