Timothy Daniel Bohan, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

NA95000225 Issued in CA

Practice address

30977 Starfire Cir
Murrieta, CA 92563-7999

Phone

(949) 933-9555

NPI assigned

Jul 6, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, shared by 4 NPIs, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital Fontana/Ontario Hospital, Fontana, CA, CCN 050140

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• CP Nursing Anesthesia Services Inc

  • Anesthesiologist Assistant
  • Apple Valley, CA
  • NPI 1316185614
  Medicare reassignment NPD
• Innovative Minimally Invasive Imaging & Therapeutics, Inc

  • Vascular & Interventional Radiology Physician
  • Rancho Cucamonga, CA
  • NPI 1952758849
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • San Diego, CA
  • NPI 1225060742
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD
• Pacific Vascular Access Care, Inc

  • Vascular & Interventional Radiology Physician
  • Downey, CA
  • NPI 1629846670

  Nurse Anesthetist, Certified Registered

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital - Fontana

  • General Acute Care Hospital
  • Fontana, CA
  • NPI 1356496772
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1558777029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30977 STARFIRE CIR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925637999",
            "telephone_number": "949-933-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30977 STARFIRE CIR",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925637999",
            "telephone_number": "949-933-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHAN",
        "first_name": "TIMOTHY",
        "middle_name": "DANIEL",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-06",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA95000225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sabrina Blum, BA, MS (IP)
• Bridget Bo- Lane
• Bernard James Boback III, DMD MS
• Ferlyn Dale Bobis, PT
• Todd Boehm, PHARMD.
• Katelyn Bohnisch
• Clarissa Carmen Boitnott
• Erin Bolanos, CADC II
• Rebecca Bolt
• Erin Emery Bolton

• Certified Registered Nurse Anesthetist in Murrieta, CA
• Providers in Murrieta, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.