Individual provider Active NPI

Jason M Balt, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
National Provider Identifier
1487945978
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9280930 Issued in FL
Practice address
4048 Evans Ave
Ste 303
Fort Myers, FL 33901-9322
Phone
(239) 332-5344
Fax
(239) 332-7246
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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 9280930 FL Primary

Addresses

Primary practice location

4048 Evans Ave
Ste 303
Fort Myers, FL 33901-9322

Mailing address

4048 Evans Ave
Ste 303
Fort Myers, FL 33901-9322
Phone (239) 332-5344

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110825000577 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981874187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians

Practice addresses (Care Compare)

40100 Hwy 27
Davenport, FL 33837-5906
Phone (863) 866-4192

6002 Berryhill Rd
Milton, FL 32570-5062
Phone (850) 626-7762

Hospital & facility affiliations

  • Adventhealth Heart of Florida Hospital, Davenport, FL, CCN 100137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9280930FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Anesthesia Consultants PA Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2015 Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 16, 2021 Accepting new patients
Medical Anesthesia and Pain Management Consultants, P.a. PastSince May 1, 2015 Accepting new patients
Jennifer Sassi PA Nurse Anesthetist, Certified Registered PastSince Feb 5, 2014 Accepting new patients

Locations

291 Southhall Ln
Ste 201
Maitland, FL 32751
Phone 40766704444

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

201 Mohawk Rd
Minneola, FL 34715
Phone (973) 979-9079

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

88 W Kaley St
Orlando, FL 32806
Phone (407) 423-0573

Organizations & group practices 5

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 1

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1487945978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "STE 303",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019322",
            "telephone_number": "239-332-5344",
            "fax_number": "239-332-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4048 EVANS AVE",
            "address_2": "STE 303",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019322",
            "telephone_number": "239-332-5344",
            "fax_number": "239-332-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALT",
        "first_name": "JASON",
        "middle_name": "M",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9280930",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 2, 2011; 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.