Individual provider Active NPI

Gary Nilsson, CRNA

  • Certified Registered Nurse Anesthetist
  • Warwick, RI
National Provider Identifier
1285710988
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA20382 Issued in RI
Practice address
455 Tollgate Rd
Warwick, RI 02886-2759
Phone
(401) 738-1516
NPI assigned
Oct 27, 2006
Last updated
Dec 6, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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 RNA20382 RI Primary

Addresses

Primary practice location

455 Tollgate Rd
Warwick, RI 02886-2759

Mailing address

690 Canton Street
Suite 325
Westwood, MA 02090-2329
Phone (781) 407-7713

Other identifiers 1

IdentifierTypeStateIssuer
NR40830MedicaidRI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050418000544 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870531296 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

444 Quaker LN
Warwick, RI 02886-0185
Phone (401) 935-1439

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean State Anesthesia Partners, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 7, 2010 Accepting new patients
University Gastroenterology, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 19, 2016 Accepting new patients
Narragansett Bay Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2016 Accepting new patients
Saint Vincent Physician Services, Inc. PastSince Aug 23, 2020 Accepting new patients
Northern Rhode Island Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

690 Canton St
Ste 325
Westwood, MA 02090
Phone 7814077713307

1407 S County Trl
Ste 410
East Greenwich, RI 02818
Phone (401) 886-4040

1526 Atwood Ave
Ste 300
Johnston, RI 02919
Phone (401) 459-3800

110 Clock Tower Sq
Ste 100
Portsmouth, RI 02871
Phone (401) 293-5600

148 W River St
Providence, RI 02904
Phone (401) 421-6306

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

75 Newman Ave
Ste 100
Rumford, RI 02916

444 Quaker Ln
Warwick, RI 02886
Phone (401) 935-1439

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 6

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1285710988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 CANTON STREET",
            "address_2": "SUITE 325",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902329",
            "telephone_number": "781-407-7713",
            "fax_number": "781-451-0998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLLGATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-738-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NILSSON",
        "first_name": "GARY",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA20382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NR40830",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.