Michael David Acquistapace, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Loma Linda, CA
NPI 1508136193 · NPPES record last updated Oct 5, 2017
Key facts
- NPI
- 1508136193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- NA4207 (CA)
- Practice address
- 11234 Anderson St
Loma Linda, CA 92354-2804 - Phone
- (909) 558-4000
- NPI assigned
- Jan 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Faculty Physicians and Surgeons of Llusm
Practice addresses (Care Compare)
11234 Anderson St
Loma Linda, CA 92354-2804
11370 Anderson St
Loma Linda, CA 92354-3450
26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174
Hospital & facility affiliations
- Loma Linda University Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.87 of 100
- Quality
- 72.13
- Promoting interoperability
- 80
- Improvement activities
- 40
- Cost
- 77.36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121218000481 | CA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 1850543919 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 653748 | CA | MD | Registered Nurse |
| RN0000170152 | TN | MD | Registered Nurse |
| NA4207 | CA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients | |
| Faculty Physicians and Surgeons of Llusm | Current |
Accepting new patients | |
| Loma Linda Univ Anesthesiology Medical Group Inc | Past | Accepting new patients |
Locations
11234 Anderson St
Rm 2532
Loma Linda, CA 92350
Phone (909) 558-4475
11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016
11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN0000170152 | TN | |
| Registered Nurse | 163W00000X | 653748 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | NA4207 | CA | Yes |
Addresses
Primary practice location
11234 Anderson St
Loma Linda, CA 92354-2804
Mailing address
1000 Creekside Dr
Redlands, CA 92373-6971
Phone (909) 213-6832
Other providers in Loma Linda, CA
- Adina Floarea Achiriloaie
- Achal Singh Achrol
- Joseph Allen Ackley
- Ana Marie Acosta
- Anna Reyna Acosta
- Linda Adams
- Matthew W Adams
- Susann Marie Adams
- Amyela Javier Adarlo
- Raychelle Harper Addo
All providers in Loma Linda, CA · Certified Registered Nurse Anesthetist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.