Individual provider Active NPI

Peter A. Okubo, CRNA

  • Certified Registered Nurse Anesthetist
  • Sunrise, FL
National Provider Identifier
1285609982
Registry record updated Sep 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3042592 Issued in FL
Practice address
2120 NW 107TH Ter
#200
Sunrise, FL 33322-3418
Phone
(954) 741-0636
Fax
(954) 741-0639
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2010

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 ARNP3042592 FL Primary

Addresses

Primary practice location

2120 NW 107TH Ter
#200
Sunrise, FL 33322-3418

Mailing address

10851 SW 30TH PL
Davie, FL 33328-1541
Phone (954) 261-4106

Other identifiers 1

IdentifierTypeStateIssuer
304183200MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051123000173 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3274553029 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP3042592FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2011 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Jan 1, 2011 Accepting new patients
Millennium Anesthesia PA Past Accepting new patients
Northwest Anesthesiologist Group PA Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1901 Ulmerton Rd
Ste 450
Clearwater, FL 33762
Phone (727) 210-8104

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

5190 SW 8th St
Coral Gables, FL 33134
Phone (305) 445-1585

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

1859 Van Buren St
Hollywood, FL 33020
Phone (954) 920-0900

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

4399 N Nob Hill Rd
Sunrise, FL 33351
Phone (566) 904-1230

2229 N Commerce Pkwy
Weston, FL 33326
Phone (954) 389-2446

111 N Lakemont Ave
Ste 2D
Winter Park, FL 32792
Phone (407) 622-2030

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1285609982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10851 SW 30TH PL",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281541",
            "telephone_number": "954-261-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 NW 107TH TER",
            "address_2": "#200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333223418",
            "telephone_number": "954-741-0636",
            "fax_number": "954-741-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKUBO",
        "first_name": "PETER",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3042592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304183200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.