Individual provider Active NPI

Crisologo Rosel Gozo, C.R.N.A

  • Certified Registered Nurse Anesthetist
  • Merrillville, IN
National Provider Identifier
1477598381
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28123203A Issued in IN
Practice address
8701 Broadway
Merrillville, IN 46410-7035
Phone
(219) 738-4929
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 28123203A IN Primary

Addresses

Primary practice location

8701 Broadway
Merrillville, IN 46410-7035

Mailing address

873 Alderbrook Court
Crown Point, IN 46307
Phone (219) 661-1057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031105000533 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032021159 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeshore Anesthesia PCGroup PAC ID 1951322353, 28 clinicians

Practice addresses (Care Compare)

1500 S Lake Park Ave
Hobart, IN 46342-6638
Phone (219) 942-0551

Hospital & facility affiliations

  • St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Medical Associates , LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2024 Accepting new patients
Munster Medical Research Foundation Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 24, 2014 Accepting new patients
St. Catherine Hospital Inc. CurrentSince Aug 9, 2014 Accepting new patients
Munster Medical Research Foundation, Inc. CurrentSince Mar 24, 2014 Accepting new patients
Lakeshore Anesthesia, P.C. Nurse Anesthetist, Certified Registered CurrentSince Aug 30, 2014 Accepting new patients
St Catherine Hospital Inc CurrentSince Aug 9, 2014 Accepting new patients
St Catherine Hospital Inc Current Accepting new patients
American Anesthesiology of Illinois, LLC Past Accepting new patients
Anesthesia Consultants of Indiana, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Methodist Anesthesia, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Crawford Avenue Anesthesia Provider Services Urbana, LLC Past Accepting new patients

Locations

4321 Fir St
East Chicago, IN 46312
Phone (219) 392-1700

1500 S Lake Park Ave
Hobart, IN 46342
Phone (219) 942-0551

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

Organizations & group practices 11

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 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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477598381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 ALDERBROOK COURT",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "46307",
            "telephone_number": "219-661-1057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107035",
            "telephone_number": "219-738-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOZO",
        "first_name": "CRISOLOGO",
        "middle_name": "ROSEL",
        "credential": "C.R.N.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28123203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.