Individual provider Active NPI

Tina Perebzak, CRNA

  • Certified Registered Nurse Anesthetist
  • Independence, OH
National Provider Identifier
1528064631
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA-06677 Issued in OH
Practice address
6000 West Creek Rd
Ste 10
Independence, OH 44131-2182
Phone
(216) 986-1309
Fax
(216) 986-1191
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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 NA-06677 OH Primary

Addresses

Primary practice location

6000 West Creek Rd
Ste 10
Independence, OH 44131-2182

Mailing address

6000 West Creek Rd
Ste 10
Independence, OH 44131-2182
Phone (216) 986-1309

Other identifiers 2

IdentifierTypeStateIssuer
000000328397OtherOHANTHEM PIN
2296037MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040325000244 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476445628 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

405 W Grand Ave
Dayton, OH 45405-7538
Phone (937) 226-3200

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NA-06677OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Feb 27, 2023 Accepting new patients
Wooster Pain and Anesthesia Center LLC CurrentSince Jul 30, 2014 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Apr 15, 2016 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2023 Accepting new patients
South Central Ohio Anesthesia LLC CurrentSince Jun 16, 2014 Accepting new patients
Premier Anesthesia of Sandusky, Inc Past Accepting new patients
Anesthesiology Associates of Akron, Inc. Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia for Children Past Accepting new patients
Mercy Anesthesiologists Inc Past Accepting new patients
Professional Anesthesia Service Inc PastSince Apr 29, 1998 Accepting new patients
Falls Anesthesia Group Inc Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

4319 Executive Cir NW
Canton, OH 44718
Phone (330) 526-0530

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

601 State Route 664 N
Ste 114
Logan, OH 43138
Phone (740) 380-8090

875 8th St NE
Massillon, OH 44646
Phone (216) 832-8761

3780 Medina Rd
Ste 120
Medina, OH 44256
Phone (330) 753-6643

34501 Aurora Rd
Ste 306
Solon, OH 44139
Phone (440) 498-0972

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

195 Wadsworth Rd
Wadsworth, OH 44281
Phone (330) 331-1000

3373 Commerce Pkwy
Ste 3
Wooster, OH 44691
Phone (330) 284-9119

1031 W Western Reserve Rd
Youngstown, OH 44514
Phone (330) 746-7691

Organizations & group practices 11

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 3

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1528064631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 WEST CREEK RD",
            "address_2": "STE 10",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312182",
            "telephone_number": "216-986-1309",
            "fax_number": "216-986-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 WEST CREEK RD",
            "address_2": "STE 10",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312182",
            "telephone_number": "216-986-1309",
            "fax_number": "216-986-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREBZAK",
        "first_name": "TINA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "NA-06677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000328397",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2296037",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.