Individual provider Active NPI

Donald A Desalvo, CRNA

  • Certified Registered Nurse Anesthetist
  • Bartlesville, OK
National Provider Identifier
1649203209
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R 88186 Issued in OK
Practice address
3500 E Frank Phillips Blvd
Bartlesville, OK 74006-2411
Phone
(918) 331-1555
Fax
(918) 333-1695
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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 680876 TX
Certified Registered Nurse Anesthetist 367500000X R 88186 OK Primary

Addresses

Primary practice location

3500 E Frank Phillips Blvd
Bartlesville, OK 74006-2411

Mailing address

PO Box 3456
Bartlesville, OK 74006-3456
Phone (918) 333-4100

Other identifiers 3

IdentifierTypeStateIssuer
20086500AMedicaidOK
010672601002OtherOKBCBSOK
200086500AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119000713 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951318476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

7301 Rogers Ave
Fort Smith, AR 72903-4100
Phone (479) 314-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 88186OKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Billins Anesthesia Inc CurrentSince Oct 20, 2020 Accepting new patients
Texas Ams PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2019 Accepting new patients

Locations

9 Freeway Dr
#A
Little Rock, AR 72204
Phone (501) 255-0410

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

1815 N Stanton St
El Paso, TX 79902
Phone (915) 533-8412

1700 E Saunders St
Laredo, TX 78041
Phone (956) 206-6971

Organizations & group practices 3

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": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1649203209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3456",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740063456",
            "telephone_number": "918-333-4100",
            "fax_number": "918-333-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 E FRANK PHILLIPS BLVD",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740062411",
            "telephone_number": "918-331-1555",
            "fax_number": "918-333-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESALVO",
        "first_name": "DONALD",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "680876",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "R 88186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20086500A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSOK",
            "identifier": "010672601002",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200086500A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.