Saja C Puthiyottil, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

6833-33 Issued in WI

Practice address

1969 W Hart Rd
Attn: Anesthesia Dept
Beloit, WI 53511-2230

Phone

(608) 364-5355

Fax

(608) 362-0417

NPI assigned

Feb 18, 2016

Last updated

Oct 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ias Illinois PCGroup PAC ID 9638530991, 79 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beloit Health System Hospital, Beloit, WI, CCN 520100

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

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.

• Ias Illinois PC

  • Anesthesiology Physician
  • Geneva, IL
  • NPI 1265118723

  WI

  Medicare reassignment Care Compare group NPD
• St. Croix Regional Medical Center

  • Critical Access Hospital
  • Saint Croix Falls, WI
  • NPI 1043240922
  Medicare reassignment NPD
• Stateline Anesthesiologists SC

  • Anesthesiology Physician
  • Beloit, WI
  • NPI 1316937519
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment NPD
• St. Croix Regional Medical Center

  • Rural Health Clinic/Center
  • Balsam Lake, WI
  • NPI 1013423219
  NPD
• Hart Road Pathology SC

  • Clinical Pathology Physician
  • Beloit, WI
  • NPI 1740459072
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Beloit Health System Inc

  dba Beloit Memorial Hospital

  • General Acute Care Hospital
  • Beloit, WI
  • NPI 1982780094
  Care Compare affiliation

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

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1285093351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 RIVERSIDE",
            "address_2": "SUITE 206",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535111500",
            "telephone_number": "608-362-7444",
            "fax_number": "608-362-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W HART RD",
            "address_2": "ATTN: ANESTHESIA DEPT",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535112230",
            "telephone_number": "608-364-5355",
            "fax_number": "608-362-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHIYOTTIL",
        "first_name": "SAJA",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-18",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "F0216734",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "6833-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285093351",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synthia Ann Potuznik, CERTIFIED HEARING IN
• Beth Ann Pouk, MS, LAT, ATC
• Brielle Evelyn Powers, MSW, APSW
• Savannah Pozdol
• Ann Louise Pruyne, OT
• Trista Marie Quinonez, SAC-IT
• Quirt Family Dentistry, SC (Gateway Dental Care)
• R Family Care Services
• Nora H Rabin, PT
• Richard E Radak, MD

• Certified Registered Nurse Anesthetist in Beloit, WI
• Providers in Beloit, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.