Individual provider Active NPI

Bryan Tamao Archpru, RN

  • Certified Registered Nurse Anesthetist
  • Santa Clara, CA
National Provider Identifier
1336447572
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4093 Issued in CA
Practice address
700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone
(408) 851-1000
NPI assigned
Mar 12, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 748852 CA
Certified Registered Nurse Anesthetist 367500000X 4093 CA Primary

Addresses

Primary practice location

700 Lawrence Expy
Santa Clara, CA 95051-5173

Mailing address

456 Madera Ave Apt 6
Sunnyvale, CA 94086-7428
Phone (808) 741-7798

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120126000382 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345417648 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians
Lifelinc Anesthesia VI PCGroup PAC ID 0749688000, 19 clinicians

Practice addresses (Care Compare)

700 Lawrence Expy
Santa Clara, CA 95051-5173
Phone (408) 851-1000

710 Lawrence Express Way
Santa Clara, CA 95051-5173
Phone (408) 851-1000

75 Neilson St
Watsonville, CA 95076-2468
Phone (831) 724-4741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4093CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mai Nursing Anesthesia PC CurrentSince Nov 20, 2021 Accepting new patients
Lifelinc Anesthesia VI PC Nurse Anesthetist, Certified Registered CurrentSince Mar 5, 2024 Accepting new patients
Permanente Medical Group, Inc CurrentSince Nov 12, 2011 Accepting new patients
Permanente Medical Group Inc CurrentSince Nov 12, 2011 Accepting new patients

Locations

429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000

1700 San Pablo Ave
Ste D
Pinole, CA 94564
Phone (510) 724-9500

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

700 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 851-5300

3003 Paul Sweet Rd
Santa Cruz, CA 95065
Phone (831) 462-1607

1720 4th St
Santa Rosa, CA 95404
Phone (707) 546-8100

3540 Mendocino Ave
Ste 200
Santa Rosa, CA 95403
Phone (707) 522-6200

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

2160 W Grant Line Rd
Ste 120
Tracy, CA 95377
Phone (209) 832-2095

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

75 Nielson St
Watsonville, CA 95076
Phone (831) 724-4741

Organizations & group practices 4

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": "1299888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1336447572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "456 MADERA AVE APT 6",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940867428",
            "telephone_number": "808-741-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LAWRENCE EXPY",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515173",
            "telephone_number": "408-851-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARCHPRU",
        "first_name": "BRYAN",
        "middle_name": "TAMAO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-12",
        "last_updated": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "748852",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "710 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.