Individual provider Active NPI

Joshua Tello, CRNA

  • Certified Registered Nurse Anesthetist
  • Worcester, MA
National Provider Identifier
1497213235
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN281962 Issued in MA
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(508) 363-5000
NPI assigned
Mar 12, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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 AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X RN281962 MA Primary

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

123 Summer St
Worcester, MA 01608-1216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190513000092 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507109683 Reassigns benefits to 1 organization
I20240304001780 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 6507109683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence Anesthesia Services LLCGroup PAC ID 4082770136, 127 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

8 Prospect St
Nashua, NH 03060-3925
Phone (603) 577-2000

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN281962MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalist Medicine Physicians of New York - Patchogue PC Multi-Specialty CurrentSince Jan 22, 2024 Accepting new patients

Locations

10 Prospect St
Ste 101
Nashua, NH 03060
Phone (603) 578-9909

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 2

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 3

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": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1497213235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLO",
        "first_name": "JOSHUA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN281962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.