Individual provider Active NPI

Michael Dominic Fallacaro, DNS, CRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1295736767
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0024157772 Issued in VA
Practice address
1602 Skipwith Rd
Richmond, VA 23229-5205
Phone
(804) 289-4937
Fax
(804) 565-6600
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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 0024157772 VA Primary

Addresses

Primary practice location

1602 Skipwith Rd
Richmond, VA 23229-5205

Mailing address

1504 Santa Rosa Rd
Suite 206
Richmond, VA 23229-5109
Phone (804) 288-4453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Richmond, Inc Past Accepting new patients
Advanced Ambulatory Anesthesia, Inc Past Accepting new patients

Organizations & group practices 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1295736767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 SANTA ROSA RD",
            "address_2": "SUITE 206",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295109",
            "telephone_number": "804-288-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SKIPWITH RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232295205",
            "telephone_number": "804-289-4937",
            "fax_number": "804-565-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLACARO",
        "first_name": "MICHAEL",
        "middle_name": "DOMINIC",
        "credential": "DNS, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024157772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.