Individual provider Active NPI

Susan Maccarthy, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
National Provider Identifier
1477527315
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP3417412 Issued in FL
Practice address
12511 World Plaza LN BLDG 50
Fort Myers, FL 33907-3991
Phone
(239) 939-2622
Fax
(239) 939-0151
NPI assigned
Feb 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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 ARNP3417412 FL Primary

Addresses

Primary practice location

12511 World Plaza LN BLDG 50
Fort Myers, FL 33907-3991

Mailing address

1501 Ricardo Ave
Fort Myers, FL 33901-6844
Phone (239) 939-2622

Other identifiers 3

IdentifierTypeStateIssuer
430063564OtherRAILROAD MEDICARE
G0365OtherFLBC/BS FL
304444100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kenneth W. Backstrand & Associates, MD,PA Past Accepting new patients
Anesthesia & Pain Consultants of SW FL PastSince Jan 1, 2019 Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients
Anesthesia Outpatient Specialists Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1477527315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 RICARDO AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016844",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12511 WORLD PLAZA LN BLDG 50",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073991",
            "telephone_number": "239-939-2622",
            "fax_number": "239-939-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCARTHY",
        "first_name": "SUSAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-16",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP3417412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430063564",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS FL",
            "identifier": "G0365",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304444100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.