Individual provider Active NPI

Marc Federico, CRNA

  • Certified Registered Nurse Anesthetist
  • Birmingham, AL
National Provider Identifier
1477910040
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-132882 Issued in AL
Practice address
701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone
(334) 247-8769
Fax
(334) 377-4417
NPI assigned
Jan 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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 1-132882 AL Primary

Addresses

Primary practice location

701 Princeton Ave SW
Birmingham, AL 35211-1303

Mailing address

PO Box 830550
Birmingham, AL 35283-0550
Phone (334) 247-8769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161117000841 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335428242 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians
Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

701 Princeton Ave SW
Birmingham, AL 35211-1303
Phone (205) 848-2925

Hospital & facility affiliations

  • St. Vincent'S East Hospital, Birmingham, AL, CCN 010011
  • Grandview Medical Center Hospital, Birmingham, AL, CCN 010104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-132882ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC Nurse Anesthetist, Certified Registered CurrentSince Aug 14, 2016 Accepting new patients
Anesthesiologists Associated PC CurrentSince Aug 14, 2016 Accepting new patients
Hospitalist Medicine Physicians of Alabama-TCS Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 1, 2021 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

200 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-3150

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 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": "1453852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1477910040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830550",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830550",
            "telephone_number": "334-247-8769",
            "fax_number": "334-377-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PRINCETON AVE SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352111303",
            "telephone_number": "334-247-8769",
            "fax_number": "334-377-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERICO",
        "first_name": "MARC",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-27",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-132882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; 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.