Individual provider Active NPI

Ryan Uptmor, CRNA

  • Certified Registered Nurse Anesthetist
  • El Paso, TX
National Provider Identifier
1508280256
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
N-38443 Issued in ID
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(509) 552-9247
NPI assigned
Feb 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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 N-38443 ID Primary

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-2705

Mailing address

PO Box 1
Asotin, WA 99402-0001
Phone (509) 552-9247

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421002445 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 4587895602 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intermountain Anesthesia Associates PLLCGroup PAC ID 2264868389, 5 clinicians
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

318 Warner Dr
Lewiston, ID 83501-4441
Phone (208) 298-1050

415 6TH St
Lewiston, ID 83501-2431
Phone (828) 398-5244

Hospital & facility affiliations

  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N-38443IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 1, 2019 Accepting new patients
St Joseph Hospital LLC CurrentSince May 1, 2017 Accepting new patients
Intermountain Anesthesia Associates PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2020 Accepting new patients

Locations

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

341 Saint Johns Way
Lewiston, ID 83501
Phone (208) 750-7462

318 Warner Dr
Lewiston, ID 83501
Phone (208) 298-1050

307 Saint Johns Way
Ste 17
Lewiston, ID 83501
Phone (208) 746-7055

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

Organizations & group practices 3

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 2

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": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1508280256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "ASOTIN",
            "state": "WA",
            "postal_code": "994020001",
            "telephone_number": "509-552-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052705",
            "telephone_number": "509-552-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPTMOR",
        "first_name": "RYAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-38443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.