Individual provider Active NPI

Abduljabar Calfos, CRNA

  • Certified Registered Nurse Anesthetist
  • North Chicago, IL
National Provider Identifier
1629853643
Registry record updated May 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP70012856 Issued in WA
Practice address
3333 Green Bay Rd
North Chicago, IL 60064-3037
Phone
(206) 356-9044
NPI assigned
Aug 28, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP70012856 WA Primary

Addresses

Primary practice location

3333 Green Bay Rd
North Chicago, IL 60064-3037

Mailing address

3333 Green Bay Rd
North Chicago, IL 60064-3037

Other practice location 1

3909 9th Ave SW
Olympia, WA 98502-5134
Phone (360) 491-8439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113004149 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4284125626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rainier Anesthesia Associates PCGroup PAC ID 4284523499, 69 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 848-6661

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP70012856WAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Anesthesia Associates PC CurrentSince Aug 9, 2025 Accepting new patients
Mind & Metabolism LLC CurrentSince Jun 26, 2025 Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 2

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 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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778976000000",
    "number": "1629853643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "206-356-9044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3909 9th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025134",
            "country_code": "US",
            "telephone_number": "360-491-8439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALFOS",
        "first_name": "ABDULJABAR",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2026-05-17",
        "certification_date": "2026-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP70012856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2026; 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.