Individual provider Active NPI

Brian R. Doucette, CRNA

  • Certified Registered Nurse Anesthetist
  • Wakefield, RI
National Provider Identifier
1285220012
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN2332347 Issued in MA
Practice address
164 Silver Lake Ave
Wakefield, RI 02879-4224
Phone
(401) 744-4900
NPI assigned
Dec 16, 2020
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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 RN2332347 MA Primary

Addresses

Primary practice location

164 Silver Lake Ave
Wakefield, RI 02879-4224

Mailing address

164 Silver Lake Ave
Wakefield, RI 02879-4224

Other identifiers 1

IdentifierTypeStateIssuer
110170927AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, VA, NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220225001942 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779760210
I20220805002659 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779760210 Reassigns benefits to 1 organization
I20230815001461 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779760210 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

117 E Kings Hwy
Eden, NC 27288-5201
Phone (336) 623-9711

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 832-7000

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-3839

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
81.07

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7050NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H. Cone Memorial Hospital Operating Corporation Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Dec 16, 2023 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 21, 2022 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Dec 16, 2023 Accepting new patients
Charlestown Ambulance & Rescue Service, Inc. PastSince Apr 1, 2011 Accepting new patients

Locations

117 E Kings Hwy
Eden, NC 27288
Phone (336) 627-6181

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

6801 Governor Gc Peery Hwy
Richlands, VA 24641
Phone (276) 523-8600

Organizations & group practices 5

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 3

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": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1285220012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SILVER LAKE AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SILVER LAKE AVE",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794224",
            "telephone_number": "401-744-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUCETTE",
        "first_name": "BRIAN",
        "middle_name": "R.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-16",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2332347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110170927A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.