Individual provider Active NPI

Emily Anne Raval, CRNA

  • Certified Registered Nurse Anesthetist
  • La Grange Park, IL
National Provider Identifier
1629439294
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209020007 Issued in IL
Practice address
904 N Waiola Ave
La Grange Park, IL 60526-1454
Phone
(319) 759-8088
NPI assigned
Mar 10, 2016
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2020

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 109859 DC
Certified Registered Nurse Anesthetist 367500000X 209020007 IL Primary

Addresses

Primary practice location

904 N Waiola Ave
La Grange Park, IL 60526-1454

Mailing address

904 N Waiola Ave
La Grange Park, IL 60526-1454
Phone (319) 759-8088

Other names 1

  • Emily Anne Rucker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160414000929 DC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466750021 Reassigns benefits to 3 organizations
I20161222000238 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466750021

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Georgetown University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Virginia, LLCGroup PAC ID 6608268826, 407 clinicians

Practice addresses (Care Compare)

2501 Parkers LN
Alexandria, VA 22306-3209
Phone (703) 664-7000

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.6 of 100Reported as group
Quality
81.55
Improvement activities
40
Cost
75.84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109859DCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Jun 28, 2022 Accepting new patients
Northstar Anesthesia of Virginia, LLC CurrentSince Mar 23, 2023 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Jun 28, 2022 Accepting new patients

Locations

2501 Parkers Ln
Alexandria, VA 22306
Phone (703) 664-7000

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

3600 Joseph Siewick Dr
Fairfax, VA 22033
Phone (703) 391-3037

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Organizations & group practices 4

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 2

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": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1629439294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 N WAIOLA AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261454",
            "telephone_number": "319-759-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 N WAIOLA AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261454",
            "telephone_number": "319-759-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVAL",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-10",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "DC",
            "license": "109859",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209020007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "RUCKER",
            "middle_name": "ANNE",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Grange Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.