Individual provider Active NPI

Michael Joseph Pereira III, DNP CRNA

  • Certified Registered Nurse Anesthetist
  • Syracuse, NY
National Provider Identifier
1396540969
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
154236 Issued in NY
Practice address
4900 Broad Rd
Syracuse, NY 13215-2265
Phone
(315) 492-5011
NPI assigned
Feb 17, 2025
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Syracuse ASC LLC 23 clinicians
Agcny Physicians PLLC 36 clinicians
Chag Anesthesia PC 54 clinicians

Practice addresses (Care Compare)

225 Greenfield Pkwy
Suite 105
Liverpool, NY 13088-6656
Phone (315) 451-6911

260 Township Blvd
Suite 20
Camillus, NY 13031-1678
Phone (315) 708-0091

4900 Broad Rd
Syracuse, NY 13215-2265
Phone (315) 498-6200

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20250617002635 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 3678084514 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
154236NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Chag Anesthesia PC CurrentSince Jun 15, 2025 Accepting new patients
Syracuse ASC LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 5, 2025 Accepting new patients
Agcny Physicians PLLC CurrentSince Jun 15, 2025 Accepting new patients

Locations

260 Township Blvd
Ste 20
Camillus, NY 13031
Phone (315) 708-0091

4309 Medical Center Dr
Fayetteville, NY 13066
Phone (315) 329-7300

225 Greenfield Pkwy
Ste 105
Liverpool, NY 13088
Phone (315) 451-6911

4900 Broad Rd
Syracuse, NY 13215
Phone (315) 492-5011

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 154236 NY Primary

Addresses

NPPES NPI Registry

Primary practice location

4900 Broad Rd
Syracuse, NY 13215-2265

Mailing address

265C Evans St Apt 8
Buffalo, NY 14221-5604
Phone (845) 901-7834

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-5540

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 25, 2026.

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1396540969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265C EVANS ST APT 8",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142215604",
            "telephone_number": "845-901-7834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "315-464-5540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREIRA",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_suffix": "III",
        "credential": "DNP CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-17",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "154236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.