Individual provider Active NPI

Jay Alan Bryngelson, CRNA

  • Certified Registered Nurse Anesthetist
  • Coos Bay, OR
National Provider Identifier
1255502001
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201807340CRNA Issued in OR
Practice address
1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone
(541) 267-5151
NPI assigned
Mar 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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 201807340CRNA OR Primary
Certified Registered Nurse Anesthetist 367500000X 112062 CO

Addresses

Primary practice location

1900 Woodland Dr
Coos Bay, OR 97420-2099

Mailing address

1900 Woodland Dr
Coos Bay, OR 97420-2099
Phone (541) 267-5151

Other practice location 1

1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbryngelson216569@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080520000191 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315016177 Reassigns benefits to 1 organization
I20240710001588 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315016177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanana Chiefs ConferenceGroup PAC ID 9537050109, 148 clinicians
Providence Anchorage Anesthesia Medical Group PCGroup PAC ID 2163414830, 52 clinicians

Practice addresses (Care Compare)

1717 W Cowles St
Fairbanks, AK 99701-5926
Phone (907) 451-6682

3300 Providence Dr
Suite 207
Anchorage, AK 99508-4620
Phone (907) 561-0005

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112062COMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Care Associates, PC CurrentSince Jul 15, 2024 Accepting new patients
Mat Su Valley Medical Center LLC CurrentSince Aug 1, 2024 Accepting new patients
Tanana Chiefs Conference CurrentSince Jan 22, 2026 Accepting new patients
Providence Anchorage Anesthesia Medical Group, P.C. CurrentSince Jan 21, 2025 Accepting new patients
Mat-Su Valley Medical Center LLC CurrentSince Aug 1, 2024 Accepting new patients
Tanana Chiefs Conference CurrentSince Jan 22, 2026 Accepting new patients
Mat Su Valley Medical Center LLC Past Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients
University Hospitals Medical Group Inc PastSince Jan 21, 2025 Accepting new patients

Locations

3300 Providence Dr
Ste 207
Anchorage, AK 99508
Phone (907) 279-0555

1717 W Cowles St
Fairbanks, AK 99701
Phone (907) 452-6682

2500 S Woodworth Loop
Palmer, AK 99645
Phone (907) 861-6000

950 E Bogard Rd
Wasilla, AK 99654
Phone (907) 352-2880

Organizations & group practices 9

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": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1255502001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WOODLAND DR",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202099",
            "telephone_number": "541-267-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 6th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211916",
            "country_code": "US",
            "telephone_number": "541-812-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYNGELSON",
        "first_name": "JAY",
        "middle_name": "ALAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-20",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201807340CRNA",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "112062",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbryngelson216569@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coos Bay, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.