Individual provider Active NPI

Michael Petri, CRNA

  • Certified Registered Nurse Anesthetist
  • Stuart, FL
National Provider Identifier
1629078878
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
285765 Issued in NY
Practice address
200 SE Hospital Ave
Anesthesia Department
Stuart, FL 34994-2346
Phone
(772) 286-0338
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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 285765 NY Primary
Certified Registered Nurse Anesthetist 367500000X ARNP 9263613 FL

Addresses

Primary practice location

200 SE Hospital Ave
Anesthesia Department
Stuart, FL 34994-2346

Mailing address

421 SE Osceola St # 3
PO Box 868
Stuart, FL 34994-2505
Phone (772) 286-0338

Other identifiers 2

IdentifierTypeStateIssuer
G4381OtherFLFLORIDA BCBS
308745000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080124000142 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830141910 Reassigns benefits to 3 organizations
I20230606001707 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830141910 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 9263613FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince May 24, 2023 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 15, 2009 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 19, 2017 Accepting new patients
Sheridan Healthcorp, Inc. Nurse Anesthetist, Certified Registered CurrentSince Sep 15, 2009 Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Jupiter Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 19, 2017 Accepting new patients
Bethesda Anesthesia Associates, Inc. Nurse Anesthetist, Certified Registered CurrentSince Oct 25, 2017 Accepting new patients
Bethesda Anesthesia Associates, Inc. Current Accepting new patients
Arapahoe Gastroenterology Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince May 15, 2023 Accepting new patients
Nassau Anesthesia Associates, P.C. PastSince May 7, 2023 Accepting new patients
North American Partners in Anesthesia LLP Past Accepting new patients

Locations

4700 Hale Pkwy
Ste 200
Denver, CO 80220
Phone (303) 758-1175

1001 Southpark Dr
Littleton, CO 80120
Phone (303) 531-5724

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

12961 Palms West Dr
Loxahatchee, FL 33470
Phone (561) 793-0437

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

60 Memorial Medical Pkwy
Palm Coast, FL 32164
Phone (385) 586-2000

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

Organizations & group practices 12

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210896000000",
    "number": "1629078878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SE OSCEOLA ST # 3",
            "address_2": "PO BOX 868",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942505",
            "telephone_number": "772-286-0338",
            "fax_number": "772-287-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE HOSPITAL AVE",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942346",
            "telephone_number": "772-286-0338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRI",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "285765",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP 9263613",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BCBS",
            "identifier": "G4381",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308745000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.