Individual provider Active NPI

Preetha Samuel, CRNA

  • Certified Registered Nurse Anesthetist
  • Plantation, FL
National Provider Identifier
1558964833
Registry record updated May 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11011610 Issued in FL
Practice address
401 NW 42ND Ave
Plantation, FL 33317-2835
Phone
(954) 587-5010
NPI assigned
Nov 18, 2020
Last updated
May 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 11011610 FL
Certified Registered Nurse Anesthetist 367500000X APRN11011610 FL Primary

Addresses

Primary practice location

401 NW 42ND Ave
Plantation, FL 33317-2835

Mailing address

13444 NW 13TH St
Pembroke Pines, FL 33028-2718
Phone (305) 746-7794

Other identifiers 1

IdentifierTypeStateIssuer
1558964833MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210611000052 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305246422 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Medicine Services of FL LLCGroup PAC ID 9537524343, 166 clinicians

Practice addresses (Care Compare)

1700 S 23Rd St
Lawnwood Regional Medical Center
Fort Pierce, FL 34950-4803
Phone (772) 461-4000

3476 S University Dr
HCA Florida University Hospital
Davie, FL 33328-2000
Phone (954) 475-4400

7201 N University Dr
Tamarac, FL 33321-2913
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11011610FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Medicine Services of FL, LLC CurrentSince Apr 1, 2023 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2021 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

340 NW Commerce Dr
Lake City, FL 32055
Phone (386) 719-9000

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

6700 Lake Nona Blvd
Orlando, FL 32827
Phone (689) 216-8000

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

3600 S Highlands Ave
Sebring, FL 33870
Phone (863) 385-6101

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622332800000",
    "number": "1558964833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13444 NW 13TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282718",
            "telephone_number": "305-746-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 NW 42ND AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172835",
            "telephone_number": "954-587-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "PREETHA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2021-05-30",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11011610",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11011610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558964833",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

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