Miranda Portwine, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2021020908 Issued in MO

Practice address

2345 Dougherty Ferry Rd
Saint Louis, MO 63122-3313

Phone

(314) 485-1101

NPI assigned

Jun 18, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Southern Illinois University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Missouri Baptist Medical CenterGroup PAC ID 3476461955, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Missouri Baptist Medical Center

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1609658905

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Metro-West Anesthesia Group Inc

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1245427335

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Orthomed Staffing LLC

  • Anesthesiology Physician
  • Addison, TX
  • NPI 1225514276

  MO

  Medicare reassignment NPD
• Parkway Pathology Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • St. Louis, MO
  • NPI 1245206960
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1346819968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14470",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631784470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 DOUGHERTY FERRY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631223313",
            "telephone_number": "314-485-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTWINE",
        "first_name": "MIRANDA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2021020908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shellsea Portillo Canales, MD
• Lee S Portnoff, M.D.
• Shulamit Menashe Portnoy, MD
• Steven Michael Portnoy, LPC
• Aileen Portugal, MD
• Katherin Elizabeth Portwood, MD
• Kaitlin J Portz, PHD
• Christopher Erik Posey, CRNA
• Grace Posey, MD
• Tracy Renee Posey, M.S., OTR/L

• Certified Registered Nurse Anesthetist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Certified Registered Nurse Anesthetist in Missouri

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