Active NPI
Andrea Leaanne Gum, CRNA
- Certified Registered Nurse Anesthetist
- Flagstaff, AZ
National Provider Identifier
1619545985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- CNRA257352
- Practice address
- 77 W Forest Ave
Flagstaff, AZ 86001-1479 - Phone
- (574) 806-3190
- NPI assigned
- Jun 14, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 28211820A | IN | |
| Certified Registered Nurse Anesthetist | 367500000X | CNRA257352 | AZ | Primary |
Addresses
Primary practice location
77 W Forest Ave
Flagstaff, AZ 86001-1479
Mailing address
1251 N Pine Cliff Dr Apt 117
Flagstaff, AZ 86001-3420
Phone (574) 806-3190
Other practice location 1
1251 N Pine Cliff Dr Apt 117
Flagstaff, AZ 86001-3420
Phone (574) 806-3190
Other practice location 2
1200 N Beaver St
Flagstaff, AZ 86001-3118
Phone (928) 779-3366
Other names 1
- Andrea Leaanne Lewandowski
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250902001535 | IN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5991109613 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northstar Anesthesia of Indiana LLC
Practice addresses (Care Compare)
24 Joliet St
Dyer, IN 46311-1705
Phone (219) 865-2141
Hospital & facility affiliations
- Franciscan Health Crown Point
- Flagstaff Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.13 of 100
- Quality
- 66.85
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.4
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNRA257352 | AZ | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northstar Anesthesia of Indiana LLC | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
Locations
24 Joliet St
Dyer, IN 46311
Phone (219) 864-2237
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Arlington, TX
- NPI 1043561541
IN, Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 5
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": "1623628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630627200000",
"number": "1619545985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 N PINE CLIFF DR APT 117",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013420",
"telephone_number": "574-806-3190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 W FOREST AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860011479",
"telephone_number": "574-806-3190"
}
],
"practiceLocations": [
{
"address_1": "1251 N Pine Cliff Dr Apt 117",
"address_purpose": "LOCATION",
"city": "Flagstaff",
"state": "AZ",
"postal_code": "860013420",
"country_code": "US",
"telephone_number": "574-806-3190",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1200 N Beaver St",
"address_purpose": "LOCATION",
"city": "Flagstaff",
"state": "AZ",
"postal_code": "860013118",
"country_code": "US",
"telephone_number": "928-779-3366",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GUM",
"first_name": "ANDREA",
"middle_name": "LEAANNE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-14",
"last_updated": "2021-09-03",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "IN",
"license": "28211820A",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AZ",
"license": "CNRA257352",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "LEWANDOWSKI",
"middle_name": "LEAANNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 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.