Individual provider Active NPI

Paula M. Dobrowolska, CRNA

  • Certified Registered Nurse Anesthetist
  • Loves Park, IL
National Provider Identifier
1417353319
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209-012071 Issued in IL
Practice address
2202 Harlem Rd
Suite 200
Loves Park, IL 61111-2754
Phone
(815) 877-4848
Fax
(815) 654-5342
NPI assigned
Nov 5, 2014
Last updated
Jun 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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 28239684A IN
Certified Registered Nurse Anesthetist 367500000X 209-012071 IL Primary

Addresses

Primary practice location

2202 Harlem Rd
Suite 200
Loves Park, IL 61111-2754

Mailing address

2202 Harlem Rd
Suite 200
Loves Park, IL 61111-2754
Phone (815) 877-4848

Other practice location 1

642 W Hospital Rd
Paoli, IN 47454-9672
Phone (812) 723-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, UT, CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20171010003710 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850614199 Reassigns benefits to 1 organization
I20230726001897 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850614199 Reassigns benefits to 3 organizations
I20240912003846 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 1850614199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Anesthesia, LLCGroup PAC ID 4486993862, 12 clinicians
NPH Anesthesia of Utah LLCGroup PAC ID 9537584313, 91 clinicians
Utah Gastroenterology LLCGroup PAC ID 9830174150, 71 clinicians

Practice addresses (Care Compare)

1393 E Sego Lily Dr
Sandy, UT 84092-4350
Phone (801) 495-5725

3580 W 9000
West Jordan, UT 84088-8812
Phone (972) 422-5941

6360 S 3000
Suite 310
Salt Lake City, UT 84121-6939
Phone (801) 944-3188

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.06 of 100Reported as group
Quality
64.36
Promoting interoperability
81
Improvement activities
40
Cost
75.01

Merit-based Incentive Payment System (MIPS)

Final score
75.45 of 100Reported as group
Quality
47.08
Promoting interoperability
95
Improvement activities
40
Cost
75.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-012071ILMDCertified Registered Nurse Anesthetist
28239684AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Gastroenterology CurrentSince Sep 1, 2023 Accepting new patients
Utah Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 3, 2023 Accepting new patients
NPH Anesthesia of Utah, LLC CurrentSince Aug 1, 2024 Accepting new patients
Utah Gastroenterology LLC Current Accepting new patients
South Central Ohio Anesthesia LLC CurrentSince Jan 1, 2019 Accepting new patients
Prowers County Hospital District CurrentSince Oct 9, 2024 Accepting new patients
Utah Gastroenterology LLC Current Accepting new patients

Locations

401 Kendall Dr
Lamar, CO 81052
Phone (719) 336-4343

8885 State Road 237
Tell City, IN 47586
Phone (812) 547-0185

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

620 Medical Dr
Ste 205
Bountiful, UT 84010
Phone (801) 298-0057

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

1034 N 500 W
Provo, UT 84604
Phone (801) 362-4119

1187 E 3900 S
Salt Lake Cty, UT 84124
Phone (801) 263-3041

6360 S 3000 E
Ste 310
Salt Lake Cty, UT 84121
Phone (801) 944-3144

10150 S Petunia Way
Lowr
Sandy, UT 84092

1393 E Sego Lily Dr
Sandy, UT 84092
Phone (801) 495-5725

1393 E Sego Lily Dr
Ste 3
Sandy, UT 84092
Phone (801) 495-5725

1393 E Sego Lily Dr
Ste E
Sandy, UT 84092

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

368 E Riverside Dr
Ste A
St George, UT 84790
Phone (435) 673-1149

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Interoperability endpoints

  • FHIR API: https://4af267b3-0b17-4e37-b82c-3c19f9bce5de.gastro.prod.fhir.ema-api.com/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1417353319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD",
            "address_2": "SUITE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 HARLEM RD",
            "address_2": "SUITE 200",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611112754",
            "telephone_number": "815-877-4848",
            "fax_number": "815-654-5342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "642 W Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Paoli",
            "state": "IN",
            "postal_code": "474549672",
            "country_code": "US",
            "telephone_number": "812-723-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOBROWOLSKA",
        "first_name": "PAULA",
        "middle_name": "M.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28239684A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-012071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; 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.