Individual provider Active NPI

Ellen Stolyar, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, IN
National Provider Identifier
1497989016
Registry record updated Apr 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
CERT# 084038 Issued in IN
Practice address
2600 Greenbush St
Lafayette, IN 47904-2477
Phone
(765) 448-8000
Fax
(765) 838-5150
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28185576A IN
Certified Registered Nurse Anesthetist 367500000X CERT# 084038 IN Primary

Addresses

Primary practice location

2600 Greenbush St
Lafayette, IN 47904-2477

Mailing address

PO Box 5545
Lafayette, IN 47903-5545
Phone (765) 448-8000

Other identifiers 2

IdentifierTypeStateIssuer
200965640MedicaidIN
000000636144OtherINANTHEM PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130204000167 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901945294 Reassigns benefits to 3 organizations
I20170313001694 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6901945294 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
SE Georgia Anesthesia, LLCGroup PAC ID 8426466137, 114 clinicians
Alta Anesthesia Associates of Georgia, PCGroup PAC ID 8729992987, 42 clinicians
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

1 Meadows Pkwy
Vidalia, GA 30474-8759
Phone (912) 535-5555

2000 Dan Proctor Dr
Saint Marys, GA 31558-3810
Phone (880) 233-2570

3100 Kemble Ave
Brunswick, GA 31520-4211
Phone (880) 233-2570

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 399-6111

4700 Waters Ave
(Memorial Health University Medical Center)
Savannah, GA 31404-6220
Phone (912) 350-8000

Hospital & facility affiliations

  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
  • Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036
  • Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
CERT# 084038INMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2013 Accepting new patients
Anesthesia Consultants PA CurrentSince Feb 1, 2017 Accepting new patients
SE Georgia Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2025 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Jun 22, 2021 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Jul 17, 2017 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

9330 State Road 54
Trinity, FL 34655
Phone (727) 834-4000

777 Gloucester St
Brunswick, GA 31520
Phone (912) 264-9930

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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 4

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": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271635200000",
    "number": "1497989016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5545",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479035545",
            "telephone_number": "765-448-8000",
            "fax_number": "765-448-8085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 GREENBUSH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042477",
            "telephone_number": "765-448-8000",
            "fax_number": "765-838-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLYAR",
        "first_name": "ELLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2010-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28185576A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "CERT# 084038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200965640",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "000000636144",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.