Individual provider Active NPI

Reve Brander, CRNA

  • Certified Registered Nurse Anesthetist
  • Sherman Oaks, CA
National Provider Identifier
1275190258
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA95001235 Issued in CA
Practice address
13916 La Maida St
Sherman Oaks, CA 91423-1907
Phone
(631) 339-5015
NPI assigned
May 24, 2019
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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 NA95001235 CA Primary
Registered Nurse 163W00000X 687781-1 NY

Addresses

Primary practice location

13916 La Maida St
Sherman Oaks, CA 91423-1907

Mailing address

13916 La Maida St
Sherman Oaks, CA 91423-1907
Phone (631) 339-5015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200312002159 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0446580062 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9090 Wilshire Blvd
Suite 102
Beverly Hills, CA 90211-1848
Phone (424) 324-9274

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
687781-1NYMDRegistered Nurse
NA95001235CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orange County Surgical Center CurrentSince Aug 1, 2024 Accepting new patients
Quality Medical Management Corp Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
Precision Anesthesia Group Inc CurrentSince Jan 23, 2020 Accepting new patients
Allied Anesthesia Medical Group Inc CurrentSince Sep 1, 2024 Accepting new patients
Sunset Anesthesia Group, a Professional Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2023 Accepting new patients

Locations

450 N Roxbury Dr
Ste 600
Beverly Hills, CA 90210
Phone (310) 651-2050

9090 Wilshire Blvd
Ste 102
Beverly Hills, CA 90211
Phone (424) 324-9274

9735 Wilshire Blvd
Ste 100
Beverly Hills, CA 90212
Phone (310) 601-3900

1124 S Main St
Ste 101
Corona, CA 92882
Phone (951) 737-6363

1400 Reynolds Ave
Ste 175
Irvine, CA 92614
Phone (949) 390-9000

1421 Oakdale Rd
Modesto, CA 95355
Phone (209) 572-0151

455 S Main St
Orange, CA 92868
Phone (714) 289-4511

1801 W Olympic Blvd
#2100
Pasadena, CA 91199

255 E Bonita Ave
Pomona, CA 91767
Phone (866) 724-4127

2900 Eureka Way
Redding, CA 96001
Phone (530) 225-8700

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1275190258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13916 LA MAIDA ST",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231907",
            "telephone_number": "631-339-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13916 LA MAIDA ST",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914231907",
            "telephone_number": "631-339-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDER",
        "first_name": "REVE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-24",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95001235",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "687781-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.