Individual provider Active NPI

Chandler Mardis Debardeleben, RN

  • Certified Registered Nurse Anesthetist
  • Orlando, FL
National Provider Identifier
1568041481
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11026371 Issued in FL
Practice address
62 Columbia St
Orlando, FL 32806-1115
Phone
(321) 214-4903
Fax
(321) 841-2196
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9467216 FL
Certified Registered Nurse Anesthetist 367500000X APRN11026371 FL Primary

Addresses

Primary practice location

62 Columbia St
Orlando, FL 32806-1115

Mailing address

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 214-4903

Other practice location 1

1500 SW 1st Ave
Ocala, FL 34471-6504
Phone (352) 351-7200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629003199 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234598863 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians
Anesthesiologists of Greater Orlando IncGroup PAC ID 7416928536, 339 clinicians

Practice addresses (Care Compare)

62 Columbia St
Orlando, FL 32806-1115
Phone (321) 843-5851

83 W Miller St
Orlando, FL 32806-2031
Phone (954) 939-5000

Hospital & facility affiliations

  • Orlando Health Hospital, Orlando, FL, CCN 100006

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN9467216FLMDCritical Care Medicine Registered Nurse
APRN11026371FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jul 1, 2023 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince May 1, 2024 Accepting new patients
Anesthesesiologists of Greater Orlando Inc CurrentSince May 1, 2024 Accepting new patients

Locations

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

62 Columbia St
Orlando, FL 32806
Phone (321) 214-4903

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

Networks

  • Freedom Health HMO Network

Organizations & group practices 6

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 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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1568041481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "321-214-4903",
            "fax_number": "321-841-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 COLUMBIA ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061115",
            "telephone_number": "321-214-4903",
            "fax_number": "321-841-2196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 SW 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344716504",
            "country_code": "US",
            "telephone_number": "352-351-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBARDELEBEN",
        "first_name": "CHANDLER",
        "middle_name": "MARDIS",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9467216",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11026371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.