Individual provider Active NPI

Albert Arredondo Jr., MSN, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Sill, OK
National Provider Identifier
1316917420
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0087300 Issued in OK
Practice address
4301 Mow-Way Rd
Rach (Attn:McUa-QC, Ms. Prescott)
Fort Sill, OK 73505-6300
Phone
(580) 458-2134
Fax
(580) 458-2314
NPI assigned
Jan 23, 2006
Last updated
Dec 18, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0087300 OK Primary
Certified Registered Nurse Anesthetist 367500000X 648163 TX
Registered Nurse 163W00000X 0087300 OK
Registered Nurse 163W00000X 648163 TX

Addresses

Primary practice location

4301 Mow-Way Rd
Rach (Attn:McUa-QC, Ms. Prescott)
Fort Sill, OK 73505-6300

Mailing address

7801 NW Brady Way
Lawton, OK 73505-0600
Phone (210) 386-8008

Other identifiers 1

IdentifierTypeStateIssuer
200114700AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070829000534 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648363168 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians
Anesthesia Medical Professionals PLLCGroup PAC ID 5991970279, 103 clinicians

Practice addresses (Care Compare)

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

4801 Integris Pkwy
Edmond, OK 73034-8864
Phone (405) 713-4565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0087300OKMDRegistered Nurse
648163TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Professionals, PLLC CurrentSince Mar 1, 2024 Accepting new patients
Ariah Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Canadian Valley Anesthesia Services Past Accepting new patients

Locations

4801 Integris Pkwy
Edmond, OK 73034
Phone (405) 657-3000

1201 Health Center Pkwy
#I
Yukon, OK 73099
Phone (405) 717-6800

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.

Hospital & facility affiliations 1

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1316917420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 NW BRADY WAY",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735050600",
            "telephone_number": "210-386-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 MOW-WAY RD",
            "address_2": "RACH (ATTN:MCUA-QC, MS. PRESCOTT)",
            "city": "FORT SILL",
            "state": "OK",
            "postal_code": "735056300",
            "telephone_number": "580-458-2134",
            "fax_number": "580-458-2314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARREDONDO",
        "first_name": "ALBERT",
        "name_suffix": "Jr.",
        "credential": "MSN, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "0087300",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "648163",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "0087300",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "648163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200114700A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sill, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.