Individual provider Active NPI

Paul D. Whaley, CRNA

  • Certified Registered Nurse Anesthetist
  • Worcester, MA
National Provider Identifier
1376637322
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN208742 Issued in MA
Practice address
55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002
Phone
(508) 334-3271
Fax
(508) 856-5911
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN11001732 FL
Certified Registered Nurse Anesthetist 367500000X RN208742 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Department of Anesthesiology
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

52 W Underwood St
Orlando, FL 32806-1110
Phone (321) 841-5111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191017001663 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6002864204 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 Underwood St
Orlando, FL 32806-1110
Phone (954) 939-5000

52 Underwood St
Orlando, FL 32806-1110
Phone (954) 939-5000

83 W Miller St
Orlando, FL 32806-2031
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11001732FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 1, 2019 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Oct 1, 2019 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
Metrowest Anesthesiology, Inc. PastSince Nov 14, 1996 Accepting new patients
Milford Anesthesia Associates Inc Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1376637322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF ANESTHESIOLOGY",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3271",
            "fax_number": "508-856-5911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 W Underwood St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328061110",
            "country_code": "US",
            "telephone_number": "321-841-5111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "PAUL",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11001732",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN208742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.