Active NPI
Mitchell Blain Olson, CRNA
- Certified Registered Nurse Anesthetist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 95001815
- Practice address
- 757 Westwood PLZ
Los Angeles, CA 90095-8358 - Phone
- (310) 825-9111
- NPI assigned
- May 11, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 9808115-3102 | UT | |
| Certified Registered Nurse Anesthetist | 367500000X | 137573 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | 95001815 | CA | Primary |
Addresses
Primary practice location
757 Westwood PLZ
Los Angeles, CA 90095-8358
Mailing address
5767 West Century Blvd Ste 400
Los Angeles, CA 90095-8358
Phone (310) 301-8771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
500 Martha Jefferson Dr
Charlottesville, VA 22911-4668
Phone (434) 654-7000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.47 of 100
- Quality
- 93.25
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.74
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 137573 | CA | MD | Marriage & Family Therapist |
| 9808115-3102 | UT | MD | Critical Care Medicine Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Anesthesia Associates, PLLC | Current | Accepting new patients | |
| SMG Anesthesia Specialists LLC | Current | Accepting new patients | |
| Regents of the University of California | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254
500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000
4600 Spotsylvania Pkwy
Fredericksburg, VA 22408
Phone (540) 498-4000
2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000
2300 Opitz Blvd
Woodbridge, VA 22191
Phone (703) 523-1000
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.
-
- Anesthesiology Physician
- Virginia Beach, VA
- NPI 1518205004
-
dba UCLA Dept of Anesthesioulogy
- Anesthesiology Physician
- Los Angeles, CA
- NPI 1326096165
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sentara Northern Virginia Medical Center
- General Acute Care Hospital
- Woodbridge, VA
- NPI 1548366404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663804800000",
"number": "1538805676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5767 WEST CENTURY BLVD STE 400",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958358",
"telephone_number": "310-301-8771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "757 WESTWOOD PLZ",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900958358",
"telephone_number": "310-825-9111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "MITCHELL",
"middle_name": "BLAIN",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-11",
"last_updated": "2022-09-22",
"certification_date": "2022-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "UT",
"license": "9808115-3102",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "137573",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "95001815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.