Individual provider Active NPI

Damian Hodges, CRNA

  • Certified Registered Nurse Anesthetist
  • Riverside, CA
National Provider Identifier
1578816211
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4297 Issued in CA
Practice address
3423 Elmwood Court
Riverside, CA 92506
Phone
(951) 532-8691
NPI assigned
Oct 18, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 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 4297 CA Primary

Addresses

Primary practice location

3423 Elmwood Court
Riverside, CA 92506

Mailing address

11234 Anderson Street
Loma Linda, CA 92354
Phone (909) 558-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121218000464 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860644911 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JP Anesthesia IncGroup PAC ID 1759750193, 14 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

1281 W C St
Colton, CA 92324-1916
Phone 9097470371300

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4297CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
JP Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Oct 22, 2024 Accepting new patients
Lgibson Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 7, 2016 Accepting new patients
Sda Services of Ca CurrentSince Aug 1, 2024 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Loma Linda Univ Anesthesiology Medical Group Inc Past Accepting new patients

Locations

1281 W C St
Colton, CA 92324
Phone (909) 580-3353

5 Holland
Ste 101
Irvine, CA 92618
Phone (949) 588-2199

25915 Barton Rd
Loma Linda, CA 92354
Phone (714) 394-6465

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

25915 Barton Rd
Ste 101
Loma Linda, CA 92354
Phone (714) 394-6465

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

9674 Archibald Ave
Ste 125
Rch Cucamonga, CA 91730
Phone (909) 296-8930

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, 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": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1578816211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-558-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3423 ELMWOOD COURT",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-532-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "DAMIAN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.