Paul Joseph Imperato, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Osage Beach, MO
NPI 1295787760 · NPPES record last updated Jan 24, 2008
Key facts
- NPI
- 1295787760
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- RN2000162294 (MO)
- Practice address
- 54 Hospital Dr
Osage Beach, MO 65065-3050 - Phone
- (573) 302-1661
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Curators of the University of Missouri
Lake Ozark Anesthesia and Associates, Inc
Practice addresses (Care Compare)
1125 Madison St
Jefferson City, MO 65101-5227
Phone (573) 635-7141
54 Hospital Dr
Osage Beach, MO 65065-3050
Phone (573) 348-8000
Hospital & facility affiliations
- Lake Regional Health System
- University of Missouri Health Care
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.23 of 100
- Quality
- 58.17
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.92
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141209002486 | MO | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5991748972 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2000162294 | MO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Curators of the University of Missouri | Current |
Accepting new patients | |
| Lake Ozark Anesthesia & Associates, Inc | Current |
Accepting new patients | |
| Curators of the University of Missouri | Current |
Accepting new patients | |
| Lander Valley Physician Practices, LLC | Past | Accepting new patients | |
| Lake of the Ozarks Pain Management Services, Inc | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1 Hospital Dr
Columbia, MO 65212
Phone (573) 882-2568
1125 Madison St
Jefferson Cty, MO 65101
Phone (573) 632-5000
54 Hospital Dr
Osage Beach, MO 65065
Phone (573) 280-2772
901 Kidwell Dr
Versailles, MO 65084
Phone (573) 378-4666
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN2000162294 | MO | Yes |
Addresses
Primary practice location
54 Hospital Dr
Osage Beach, MO 65065-3050
Mailing address
5151 Highway 54 PO Box 840
Suite F
Osage Beach, MO 65065
Phone (573) 302-1661
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 917196404 | Medicaid | MO |
NPI Registry JSON
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201132800000",
"number": "1295787760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5151 HIGHWAY 54 PO BOX 840",
"address_2": "SUITE F",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "65065",
"telephone_number": "573-302-1661",
"fax_number": "573-302-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 HOSPITAL DR",
"city": "OSAGE BEACH",
"state": "MO",
"postal_code": "650653050",
"telephone_number": "573-302-1661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IMPERATO",
"first_name": "PAUL",
"middle_name": "JOSEPH",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2008-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MO",
"license": "RN2000162294",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "917196404",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Osage Beach, MO
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- Dylan Hymes
- Adam Lloyd Ilgen
- Michelle Iwanowicz
- Tammy Leah Jebsen
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All providers in Osage Beach, MO · Certified Registered Nurse Anesthetist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.