Individual provider Active NPI

Charles B. Magich Jr., CRNA

  • Certified Registered Nurse Anesthetist
  • Coral Springs, FL
National Provider Identifier
1346259470
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11002490 Issued in FL
Practice address
3001 Coral Springs Drive
Ste 200
Coral Springs, FL 33065-4172
Phone
(954) 837-1201
Fax
(954) 752-1660
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R108865 MD
Certified Registered Nurse Anesthetist 367500000X APRN11002490 FL Primary

Addresses

Primary practice location

3001 Coral Springs Drive
Ste 200
Coral Springs, FL 33065-4172

Mailing address

PO Box 64795
Baltimore, MD 21264-4795
Phone (410) 328-6704

Other practice location 1

201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone (954) 485-5666

Other identifiers 2

IdentifierTypeStateIssuer
104763500MedicaidFL
213307500MedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address credentialing@gastrohealth.com Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000679 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991744880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3001 Coral Springs Dr
Coral Springs, FL 33065-3829
Phone (954) 837-1201

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002490FLMDCertified Registered Nurse Anesthetist
R108865MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Galloway Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2022 Accepting new patients
Anesco North Broward LLC CurrentSince Nov 12, 2019 Accepting new patients
Galloway Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2022 Accepting new patients

Locations

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

3601 W Commercial Blvd
Ste 5
Ft Lauderdale, FL 33309
Phone (954) 485-2002

3601 W Commercial Blvd
Ste 4
Ft Lauderdale, FL 33309

9415 SW 72nd St
Ste 274
Miami, FL 33173
Phone (305) 468-4184

7600 SW 87th Ave
Ste 100
Miami, FL 33173
Phone (786) 235-3750

Organizations & group practices 3

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1346259470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64795",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644795",
            "telephone_number": "410-328-6704",
            "fax_number": "410-328-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 CORAL SPRINGS DRIVE",
            "address_2": "STE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654172",
            "telephone_number": "954-837-1201",
            "fax_number": "954-752-1660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Sample Rd",
            "address_purpose": "LOCATION",
            "city": "Deerfield Beach",
            "state": "FL",
            "postal_code": "330643502",
            "country_code": "US",
            "telephone_number": "954-485-5666",
            "fax_number": "954-484-1651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAGICH",
        "first_name": "CHARLES",
        "middle_name": "B.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R108865",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11002490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104763500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213307500",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@gastrohealth.com",
            "affiliation": "N",
            "endpointDescription": "credentialing email address for Charles Magich",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "3001 Coral Springs Drive",
            "address_2": "Ste 200",
            "city": "Coral Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330654172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.