Vincent Fredrick Icalia

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

TEMP836563 Issued in NV

Practice address

9127 W Russell Rd Ste 110
Las Vegas, NV 89148-1253

Phone

(702) 878-0070

Fax

(702) 209-2064

NPI assigned

Dec 15, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV, HI2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan IncGroup PAC ID 1850205360, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Hospital, Honolulu, HI, CCN 120011

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan Inc

  • Radiology Clinic/Center
  • Honolulu, HI
  • NPI 1063515567
  Medicare reassignment Care Compare group NPD
• Honolulu Spine Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
  • NPI 1093830325
  Medicare reassignment NPD
• Pec Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Pearl City, HI
  • NPI 1528305208

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Waiola Anesthesia Partners LLC

  • Certified Registered Nurse Anesthetist
  • Kapolei, HI
  • NPI 1730044983

  Nurse Anesthetist, Certified Registered

  NPD Authorized official
• Amin, Dunckelmeyer and Luu PLLC

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1093410045
  Medicare reassignment
• Red Rock Anesthesia Consultants LLC

  • Anesthesiology Physician
  • Las Vegas, NV
  • NPI 1235660002
  Medicare reassignment
• Arizona Anesthesia Consultants, Inc.

  • Anesthesiology Physician
  • Glendale, AZ
  • NPI 1740402940

  Nurse Anesthetist, Certified Registered

  NPD
• Kaiser Foundation Health Plan Inc

  • Clinical Medical Laboratory
  • Honolulu, HI
  • NPI 1033232087
  NPD
• Kaiser Foundation Health Plan, Inc

  • Rural Health Clinic/Center
  • Kahuku, HI
  • NPI 1245773936
  NPD

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

• Kaiser Foundation Hospitals

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1396813861
  Care Compare affiliation

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1447846316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840857",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840857",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9127 W RUSSELL RD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891481253",
            "telephone_number": "702-878-0070",
            "fax_number": "702-209-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICALIA",
        "first_name": "VINCENT",
        "middle_name": "FREDRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-15",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NV",
            "license": "TEMP836563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basel Chakib Ibrahim
• Ennis Ibrahim, DO
• Khalil Osama Ibrahim
• Messeret Ibrahim
• Subhi Ibrahim, RN
• Icare Health Services LLC
• Icare Healthcare Network LLC
• Icare Home Health Agency LLC
• Icare Las Vegas
• Icare Wellness & Counseling LLC

• Certified Registered Nurse Anesthetist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Certified Registered Nurse Anesthetist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.