Individual provider Active NPI

Michael C. Mauney, CRNA

  • Certified Registered Nurse Anesthetist
  • Pensacola, FL
National Provider Identifier
1497086862
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9301405 Issued in FL
Practice address
4901 Grande Dr
Pensacola, FL 32504-5935
Phone
(850) 477-7042
Fax
(850) 474-9060
NPI assigned
Jan 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 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 ARNP9301405 FL Primary

Addresses

Primary practice location

4901 Grande Dr
Pensacola, FL 32504-5935

Mailing address

4901 Grande Dr
Pensacola, FL 32504-5935
Phone (850) 477-7042

Other identifiers 5

IdentifierTypeStateIssuer
116391MedicaidAL
001858800MedicaidFL
593-04259OtherALBLUE CROSS BLUE SHIELD
P00838942OtherMEDICARE RAILROAD
G007HOtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260505004643 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648315341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Anesthesia of Montgomery PCGroup PAC ID 5799684148, 117 clinicians

Practice addresses (Care Compare)

2105 E S Blvd
Montgomery, AL 36116-2409
Phone (334) 286-3579

Hospital & facility affiliations

  • Baptist Medical Center South Hospital, Montgomery, AL, CCN 010023

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ams Sacred Heart LLC CurrentSince Dec 1, 2015 Accepting new patients
Ams Anesthetist Services LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2012 Accepting new patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients

Locations

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

3871 Harlem Rd
Ste 202
Buffalo, NY 14215

2157 Main St
Buffalo, NY 14214
Phone (716) 862-1501

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": "1264377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1497086862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUNEY",
        "first_name": "MICHAEL",
        "middle_name": "C.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-25",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9301405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116391",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001858800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "593-04259",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00838942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G007H",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.