Individual provider Active NPI

David Velasco, CRNA

  • Certified Registered Nurse Anesthetist
  • Crown Point, IN
National Provider Identifier
1609360965
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209020777 Issued in IL
Practice address
1201 S Main St
Crown Point, IN 46307-8481
Phone
(219) 757-6390
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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 28227148A IN
Certified Registered Nurse Anesthetist 367500000X 209020777 IL Primary

Addresses

Primary practice location

1201 S Main St
Crown Point, IN 46307-8481

Mailing address

1302 Franklin Ave
Normal, IL 61761-3551

Other practice location 1

1302 Franklin Ave
Normal, IL 61761-3551
Phone (309) 268-5867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180926003849 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082965231 Reassigns benefits to 5 organizations
I20200831001731 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082965231 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Redreef Anesthesia Associates Chartered Indiana LLCGroup PAC ID 7012459647, 36 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

120 N Oak St
Hinsdale, IL 60521-3829
Phone (630) 856-9000

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 352-1200

600 Grant St
Gary, IN 46402-6001
Phone (888) 851-4642

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209020777ILMDCertified Registered Nurse Anesthetist
28227148AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Anesthesiologists, SC CurrentSince Feb 21, 2022 Accepting new patients
Beacon Medical Group Inc CurrentSince Apr 1, 2022 Accepting new patients
Northstar Anesthesia of Indiana II, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 28, 2020 Accepting new patients
Carle Health Care Incorporated CurrentSince Oct 4, 2025 Accepting new patients
Carle Bromenn Medical Center CurrentSince Mar 28, 2024 Accepting new patients
Carle Bromenn Medical Center CurrentSince Mar 28, 2024 Accepting new patients
Redreef Anesthesia Associates Chartered Indiana LLC CurrentSince Apr 25, 2024 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. CurrentSince Jul 11, 2022 Accepting new patients
Roseland Community Hospital Association CurrentSince Aug 19, 2022 Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. Nurse Anesthetist, Certified Registered CurrentSince Jul 11, 2022 Accepting new patients
Northstar Anesthesia of Indiana LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2018 Accepting new patients
Carle West Physician Group Inc CurrentSince Mar 28, 2024 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 28, 2023 Accepting new patients
Roseland Community Hospital Association Nurse Anesthetist, Certified Registered CurrentSince Aug 19, 2022 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2020 Accepting new patients
Associated Anesthesiologists, S.C. CurrentSince Feb 21, 2022 Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

7937 S Harlem Ave
Burbank, IL 60459

45 W 111th St
Chicago, IL 60628
Phone (773) 995-3000

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1300 Franklin Ave
Ste 100
Normal, IL 61761
Phone (309) 268-3503

1302 Franklin Ave
Normal, IL 61761
Phone (309) 268-5867

6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393

530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393

1016 Featherstone Rd
Rockford, IL 61107
Phone (815) 226-3300

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

12750 Saint Francis Dr
Crown Point, IN 46307
Phone (219) 738-2100

11051 Broadway
Ste B
Crown Point, IN 46307
Phone (219) 308-0193

1201 S Main St
Crown Point, IN 46307
Phone (219) 738-2100

24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237

4411 Washington Ave
Ste 100
Evansville, IN 47714
Phone (313) 637-9861

6913 N Main St
Granger, IN 46530
Phone (574) 647-1500

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

8701 Broadway
Merrillville, IN 46410
Phone (219) 738-4926

701 Superior Ave
Munster, IN 46321
Phone (219) 922-4200

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Interoperability endpoints

  • Direct secure messaging: dvelascocrna407700@carlehiedirect.net

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 3

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1609360965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MAIN ST",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463078481",
            "telephone_number": "219-757-6390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617613551",
            "country_code": "US",
            "telephone_number": "309-268-5867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28227148A",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209020777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.