Matthew Allyn Fagert, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

200540820 Issued in OR

Practice address

500 SW Ramsey Ave
Grants Pass, OR 97527

Phone

(541) 472-7000

NPI assigned

Mar 5, 2007

Last updated

Jun 18, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rogue Anesthesia LLCGroup PAC ID 9830162197, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Rogue Anesthesia LLC

  • Anesthesiology Physician
  • Grants Pass, OR
  • NPI 1043248917
  Medicare reassignment Care Compare group NPD
• Sleepytime Anesthesia

  • Certified Registered Nurse Anesthetist
  • Grants Pass, OR
  • NPI 1245997980

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Asante Physician Partners

  • Family Medicine Physician
  • Medford, OR
  • NPI 1922381326
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371513600000",
    "number": "1265561377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EAST BARNETT RD",
            "address_2": "SUITE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-789-5250",
            "fax_number": "541-789-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SW RAMSEY AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "97527",
            "telephone_number": "541-472-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGERT",
        "first_name": "MATTHEW",
        "middle_name": "ALLYN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2013-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "200540820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049337",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evolve Counseling & Neurofeedback Center Inc
• Eye Care Group of Southern Oregon, LLC (Eye Care Group)
• Eye to Eye Counseling and Therapy LLC
• Eyeglass Center
• Agnes Olaolu Ezekiel, PMHNP-BC
• Susan R Fahey, MSN
• Daniela Falcone, NP
• Family Friends
• Family Solutions
• Rebecca Farmer

• Certified Registered Nurse Anesthetist in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Certified Registered Nurse Anesthetist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.