Individual provider Active NPI

Scott Robert Doyle, CRNA

  • Certified Registered Nurse Anesthetist
  • Waterloo, IA
National Provider Identifier
1306890819
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
D109377 Issued in IA
Practice address
1015 S Hackett Rd Ste B
Waterloo, IA 50701-3543
Phone
(319) 406-5990
Fax
(319) 234-5994
NPI assigned
May 20, 2006
Last updated
Jan 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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 D109377 IA Primary

Addresses

Primary practice location

1015 S Hackett Rd Ste B
Waterloo, IA 50701-3543

Mailing address

PO Box 2758
Waterloo, IA 50704-2758
Phone (319) 235-5390

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318000237 IA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3779473251 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Gi PCGroup PAC ID 2567930985, 22 clinicians

Practice addresses (Care Compare)

1015 S Hackett Rd
Waterloo, IA 50701-3500
Phone (319) 234-5990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D109377IAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Anesthesia & Pain Mngmt LLP CurrentSince Apr 7, 2025 Accepting new patients
Grinnell Regional Medical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 11, 2019 Accepting new patients
Metro Anesthesia & Pain Mngmt LLP Nurse Anesthetist, Certified Registered CurrentSince Apr 7, 2025 Accepting new patients
Cedar Valley Medical Specialists PC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1015 Union St
Boone, IA 50036
Phone (515) 432-3140

202 4th Ave
Ste 201
Grinnell, IA 50112
Phone (515) 224-1414

210 4th Ave
Grinnell, IA 50112
Phone (641) 236-2055

1015 S Hackett Rd
Ste B
Waterloo, IA 50701
Phone (319) 406-5990

1753 W Ridgeway Ave
Ste 107
Waterloo, IA 50701
Phone (319) 833-5907

5901 Westown Pkwy
Ste 210
West Des Moines, IA 50266
Phone (515) 221-9222

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1306890819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390",
            "fax_number": "319-233-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S HACKETT RD STE B",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013543",
            "telephone_number": "319-406-5990",
            "fax_number": "319-234-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOYLE",
        "first_name": "SCOTT",
        "middle_name": "ROBERT",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D109377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.