Individual provider Active NPI

Stefan M. Bolin, CRNA

  • Certified Registered Nurse Anesthetist
  • Naples, FL
National Provider Identifier
1346445822
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ANT9165703 Issued in FL
Practice address
4949 Tamiami TRL N
Ste 206
Naples, FL 34103-3027
Phone
(239) 261-1158
Fax
(239) 261-4232
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ANT9165703 FL Primary

Addresses

Primary practice location

4949 Tamiami TRL N
Ste 206
Naples, FL 34103-3027

Mailing address

PO Box 413012
Naples, FL 34101-3012
Phone (239) 261-1158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070925000161 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800980699 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Anesthesia Solutions of Florida II, LLCGroup PAC ID 7911323720, 327 clinicians

Practice addresses (Care Compare)

6101 Pine Ridge Rd
Naples, FL 34119-3900
Phone (239) 348-4000

Hospital & facility affiliations

  • Physicians Regional Medical Center - Pine Ridge Hospital, Naples, FL, CCN 100286

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ANT9165703FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 16, 2017 Accepting new patients
Capital Anesthesia Solutions of Florida II, LLC CurrentSince Jul 13, 2020 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 16, 2017 Accepting new patients
Key Practice Management Solutions LLC Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

11190 Health Park Blvd
Naples, FL 34110
Phone (239) 300-9721

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

540 The Rialto
Venice, FL 34285
Phone (866) 481-2553

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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 2

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346445822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413012",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341013012",
            "telephone_number": "239-261-1158",
            "fax_number": "239-261-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 TAMIAMI TRL N",
            "address_2": "STE 206",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033027",
            "telephone_number": "239-261-1158",
            "fax_number": "239-261-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "STEFAN",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ANT9165703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.