Individual provider Active NPI

Ethan Jarrad Ehrlich, CRNA

  • Certified Registered Nurse Anesthetist
  • Hollywood, FL
National Provider Identifier
1366680449
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ANT9227808 Issued in FL
Practice address
3501 Johnson St
Hollywood, FL 33021-5421
Phone
(954) 838-2588
Fax
(954) 851-1758
NPI assigned
Jan 28, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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 ANT9227808 FL Primary

Addresses

Primary practice location

3501 Johnson St
Hollywood, FL 33021-5421

Mailing address

1613 Harrison Pkwy
Suite 200
Sunrise, FL 33323-2896
Phone (954) 838-2588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110214000173 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9537217575 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vallot Nurse Anesthesia, a Professional CorporationGroup PAC ID 8820319213, 16 clinicians
Folsom Anesthesia LPGroup PAC ID 4981956729, 13 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

1420 E Roseville Pkwy
Suite 100
Roseville, CA 95661-3080
Phone (916) 677-2488

1671 Creekside Dr
Suite 100
Folsom, CA 95630-3890
Phone (214) 739-9544

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-2011

4860 Y St
Sacramento, CA 95817-2307

4861 Y St
Sacramento, CA 95817-2307
Phone (916) 734-2525

4868 X St
Sacramento, CA 95817-2205

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
ANT9227808FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Folsom Anesthesia LP Nurse Anesthetist, Certified Registered CurrentSince Oct 9, 2019 Accepting new patients
Regents of the Univ of Ca CurrentSince Jan 18, 2011 Accepting new patients
Regents of the Univ of Ca Nurse Anesthetist, Certified Registered CurrentSince Jan 18, 2011 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Surgical Anesthesia Services of California Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

1671 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (214) 739-9544

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2315 Stockton Blvd
Ste 1200
Sacramento, CA 95817
Phone (916) 734-5394

2805 J St
Ste 200
Sacramento, CA 95816
Phone (916) 231-8755

2315 Stockton Blvd
#5
Sacramento, CA 95817
Phone (916) 703-3050

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

Organizations & group practices 7

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 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": "1233100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1366680449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 HARRISON PKWY",
            "address_2": "SUITE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2588",
            "fax_number": "954-851-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 JOHNSON ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215421",
            "telephone_number": "954-838-2588",
            "fax_number": "954-851-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHRLICH",
        "first_name": "ETHAN",
        "middle_name": "JARRAD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-28",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ANT9227808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; 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.