Individual provider Active NPI

Michael Maldonado, CRNA

  • Certified Registered Nurse Anesthetist
  • Erie, PA
National Provider Identifier
1295962967
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN527570L Issued in PA
Practice address
200 State St
Erie, PA 16507-1420
Phone
(814) 453-3900
Fax
(814) 453-2847
NPI assigned
Jun 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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 RN527570L PA Primary

Addresses

Primary practice location

200 State St
Erie, PA 16507-1420

Mailing address

3998 Fair Ridge Drive
Suite 300
Fairfax, VA 22033-2921
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
P00853635OtherNJRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000697 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214083252 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia, Pennsylvania , LLCGroup PAC ID 7517960834, 302 clinicians

Practice addresses (Care Compare)

201 State St
Erie, PA 16550-0002
Phone (814) 877-6000

232 W 25TH St
Ahn Saint Vincent Anesthesia
Erie, PA 16544-0002
Phone (814) 452-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia, Pennsylvania , LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2010 Accepting new patients
St Vincent Medical Education and Research Institute Inc CurrentSince Mar 24, 2025 Accepting new patients

Locations

155 E State St
Albion, PA 16401
Phone (814) 756-4917

206 E Brown St
East Stroudsburg, PA 18301
Phone (570) 420-4951

312 W 25th St
Erie, PA 16502
Phone (814) 452-5309

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

200 State St
Erie, PA 16507
Phone (814) 453-3900

201 State St
Erie, PA 16550
Phone (814) 877-2137

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.

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": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1295962967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DRIVE",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332921",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 STATE ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165071420",
            "telephone_number": "814-453-3900",
            "fax_number": "814-453-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-19",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN527570L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00853635",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.