Individual provider Active NPI

Sebastian Boy Mission Maderazo, CRNA

  • Certified Registered Nurse Anesthetist
  • Oroville, CA
National Provider Identifier
1508437823
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95002379 Issued in CA
Practice address
2767 Olive Hwy
Oroville, CA 95966-6118
Phone
(530) 533-8500
NPI assigned
Jul 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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 95107437 CA
Certified Registered Nurse Anesthetist 367500000X 95002379 CA Primary

Addresses

Primary practice location

2767 Olive Hwy
Oroville, CA 95966-6118

Mailing address

2767 Olive Hwy
Oroville, CA 95966-6118

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smaderazo@email.arizona.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904000900 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880134980 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orohealth Corporation a Non Profit Healthcare SystemGroup PAC ID 4082501192, 126 clinicians

Practice addresses (Care Compare)

2767 Olice Hwy
Oroville, CA 95966-6118

2767 Olive Hwy
Oroville, CA 95966-6118

Hospital & facility affiliations

  • Oroville Hospital Hospital, Oroville, CA, CCN 050030
  • Enloe Health Hospital, Chico, CA, CCN 050039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95107437CAMDRegistered Nurse
95002379CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Regional Anesthesia Associates Inc CurrentSince Aug 1, 2024 Accepting new patients
Orohealth Corporation a Non Profit Healthcare System Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2024 Accepting new patients
University of Arizona Nursing and Health Associates PastSince Jul 1, 2021 Accepting new patients

Locations

1205 E North St
Manteca, CA 95336
Phone (209) 239-8301

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

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": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1508437823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 OLIVE HWY",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959666118",
            "telephone_number": "530-533-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADERAZO",
        "first_name": "SEBASTIAN BOY",
        "middle_name": "MISSION",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-07",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95107437",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smaderazo@email.arizona.edu",
            "affiliation": "N",
            "endpointDescription": "University of Arizona",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1305 N Martin Ave",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857210001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.