Individual provider Active NPI

Sean Charles Pacamalan, CRNA

  • Certified Registered Nurse Anesthetist
  • Davenport, FL
National Provider Identifier
1366151144
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11026948 Issued in FL
Practice address
40100 Highway 27
Davenport, FL 33837-5906
Phone
(407) 222-2259
NPI assigned
Nov 21, 2022
Last updated
Sep 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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 APRN11026948 FL Primary

Addresses

Primary practice location

40100 Highway 27
Davenport, FL 33837-5906

Mailing address

2717 Maitland Crossing Way Apt 4202
Orlando, FL 32810-7137

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230919002893 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789048091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 866-4192

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2023 Accepting new patients

Locations

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

40100 Highway 27
#C
Davenport, FL 33837
Phone (863) 866-4192

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

6733 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-8242

Organizations & group practices 1

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 1

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": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1366151144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 MAITLAND CROSSING WAY APT 4202",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328107137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375906",
            "telephone_number": "407-222-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACAMALAN",
        "first_name": "SEAN",
        "middle_name": "CHARLES",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11026948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.