Individual provider Active NPI

Isidro A Paulino

  • Certified Registered Nurse Anesthetist
  • Battle Creek, MI
National Provider Identifier
1649206624
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704178947 Issued in MI
Practice address
300 North Ave
Battle Creek, MI 49017-3307
Phone
(616) 966-8000
NPI assigned
Jun 23, 2006
Last updated
Aug 24, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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 4704178947 MI Primary

Addresses

Primary practice location

300 North Ave
Battle Creek, MI 49017-3307

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (517) 787-6440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190815000831 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951458256 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Dec 30, 2023 Accepting new patients
New York Gi Center LLC CurrentSince Oct 28, 2019 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince Sep 3, 2019 Accepting new patients
Interfaith Professional Physician Services, P.C. CurrentSince Sep 7, 2022 Accepting new patients
Montefiore Medical Center CurrentSince Dec 30, 2023 Accepting new patients
Bronx Anesthesia Services, PC CurrentSince Jul 18, 2019 Accepting new patients

Locations

1200 Waters Pl
Ste M117
Bronx, NY 10461
Phone (718) 863-0575

111 E 210th St
Bronx, NY 10467

4422 3rd Ave
Bronx, NY 10457
Phone (718) 960-3917

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

300 Community Dr
Manhasset, NY 11030

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

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 4

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1649206624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173307",
            "telephone_number": "616-966-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULINO",
        "first_name": "ISIDRO",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704178947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; 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.