Individual provider Active NPI

Kristoffer Pernsteiner

  • Certified Registered Nurse Anesthetist
  • Miami Shores, FL
National Provider Identifier
1619623956
Registry record updated Jun 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11033110 Issued in FL
Practice address
11300 NE 2ND Ave
Miami Shores, FL 33161-6695
Phone
(130) 589-9300
NPI assigned
Feb 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X RN9344078 FL
Student in an Organized Health Care Education/Training Program 390200000X
Certified Registered Nurse Anesthetist 367500000X 11033110 FL Primary

Addresses

Primary practice location

11300 NE 2ND Ave
Miami Shores, FL 33161-6695

Mailing address

11104 Glenmoor Dr
West Palm Beach, FL 33409-2778
Phone (561) 312-5392

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913002838 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 6204376452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PBG Team Anesthesia PAGroup PAC ID 5092856757, 46 clinicians

Practice addresses (Care Compare)

3360 Burns Rd
Palm Beach Gardens, FL 33410-4323
Phone (800) 694-7225

Hospital & facility affiliations

  • Palm Beach Gardens Medical Center Hospital, Palm Beach Gardens, FL, CCN 100176

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9344078FLMDCritical Care Medicine Registered Nurse
11033110FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
PBG Team Anesthesia PA Nurse Anesthetist, Certified Registered CurrentSince Aug 20, 2024 Accepting new patients

Locations

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

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.

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": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717200000000",
    "number": "1619623956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 GLENMOOR DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334092778",
            "telephone_number": "561-312-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 NE 2ND AVE",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331616695",
            "telephone_number": "130-589-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERNSTEINER",
        "first_name": "KRISTOFFER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-24",
        "last_updated": "2024-06-01",
        "certification_date": "2024-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "RN9344078",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11033110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.