Robert G. Koressel, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

ARNP1521992 Issued in FL

Practice address

4901 Grande Dr
Pensacola, FL 32504-5935

Phone

(850) 477-7042

Fax

(850) 474-9060

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• West Florida Medical Center Clinic PA

  • Ambulatory Surgical Clinic/Center
  • Pensacola, FL
  • NPI 1043396245
  NPD (past)

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1366444796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORESSEL",
        "first_name": "ROBERT",
        "middle_name": "G.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP1521992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430068703",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303902100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009958570",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "G0474",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS & BLUESHIELD",
            "identifier": "59048146",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill R Konzelman Wilson, P.A.
• Catherine Koontz
• Elena Alona Kopko, DDS
• Lindsay W Koppes, DPT
• Donna L Korando, P.A-C
• Francisco Chavarria Kortman, D.O.
• Andrew E Kortz, MD
• Cassie Kostevicki, PHARMD
• Darpan Pravin Kothia
• Kotlarz ENT and Facial Plastic Surgery

• Certified Registered Nurse Anesthetist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.