Individual provider Active NPI

Bruce O'Donnell, CRNA

  • Certified Registered Nurse Anesthetist
  • Lewiston, ME
National Provider Identifier
1497764815
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9292231 Issued in FL
Practice address
300 Main St
Lewiston, ME 04240-7027
Phone
(207) 795-5775
Fax
(207) 795-5653
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA83185 ME
Certified Registered Nurse Anesthetist 367500000X ARNP9292231 FL Primary

Addresses

Primary practice location

300 Main St
Lewiston, ME 04240-7027

Mailing address

300 Main St
Lewiston, ME 04240-7027
Phone (207) 795-5775

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200312000963 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234294117 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9292231FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology Services of Florida, Inc. CurrentSince Jan 14, 2024 Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc CurrentSince Oct 1, 2021 Accepting new patients
Advanced Gastroenterology of Naples, LLC CurrentSince Feb 22, 2020 Accepting new patients
US Anesthesia Partners of Florida Inc. Nurse Anesthetist, Certified Registered CurrentSince Feb 26, 2020 Accepting new patients
Anesthesia & Pain Consultants of SW FL CurrentSince Oct 1, 2021 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937

12511 World Plaza Ln
Bldg 50
Fort Myers, FL 33907
Phone 2399392622 ext. 300

3439 Pine Ridge Rd
Naples, FL 34109
Phone (239) 593-9599

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EDCGDD

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1497764815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-5775",
            "fax_number": "207-795-5653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-5775",
            "fax_number": "207-795-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "BRUCE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA83185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9292231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.