Individual provider Active NPI

Andre Lamont Milburn, CRNA

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1356329874
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3290 Issued in CA
Practice address
420 E 3Rd Street
Suite 1005
Los Angeles, CA 90013-1648
Phone
(213) 935-8795
Fax
(213) 895-8786
NPI assigned
Jan 4, 2006
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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 3290 CA Primary

Addresses

Primary practice location

420 E 3Rd Street
Suite 1005
Los Angeles, CA 90013-1648

Mailing address

420 E 3Rd Street
Suite 1005
Los Angeles, CA 90013-1648
Phone (213) 935-8795

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110131000112 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284724352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comfort Anesthesia Associates IncGroup PAC ID 6002975489, 77 clinicians

Practice addresses (Care Compare)

115 Mall Dr
Hanford, CA 93230-5786
Phone (559) 582-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3290CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Comfort Anesthesia Associates Inc CurrentSince Jan 1, 2021 Accepting new patients
Brookside Anesthesia Group CurrentSince Sep 19, 2016 Accepting new patients
Verde Valley Medical Center Past Accepting new patients
Metro Nursing Anesthesia Services Inc Nurse Anesthetist, Certified Registered PastSince Dec 22, 2020 Accepting new patients

Locations

2635 G St
Bakersfield, CA 93301
Phone (661) 633-1500

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

8436 W 3rd St
Ste 700
Los Angeles, CA 90048
Phone (310) 274-8228

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

869 N Cherry St
Tulare, CA 93274
Phone (559) 326-2800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1356329874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E 3RD STREET",
            "address_2": "SUITE 1005",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131648",
            "telephone_number": "213-935-8795",
            "fax_number": "213-935-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E 3RD STREET",
            "address_2": "SUITE 1005",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900131648",
            "telephone_number": "213-935-8795",
            "fax_number": "213-895-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILBURN",
        "first_name": "ANDRE",
        "middle_name": "LAMONT",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; 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.