Carrie Denise Mikkelson-Heredia, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3288 Issued in CA

Practice address

450 N Roxbury Dr
Suite 600
Beverly Hills, CA 90210-4232

Phone

(310) 651-2280

Fax

(310) 651-2260

NPI assigned

Nov 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Southern California Keck School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tip Top Anesthesia Group IncGroup PAC ID 0941429872, 45 clinicians

Sunset Anesthesia Group a Professional Nursing CorporationGroup PAC ID 2769842293, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Sunset Anesthesia Group, a Professional Nursing Corporation

  • Certified Registered Nurse Anesthetist
  • Sherman Oaks, CA
  • NPI 1932891678

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Tip Top Anesthesia Group Inc

  • Licensed Practical Nurse
  • Beverly Hills, CA
  • NPI 1508283698
  Medicare reassignment Care Compare group NPD
• Allied Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1346267267
  Medicare reassignment NPD
• Precision Anesthesia Group Inc

  • Specialist
  • Beverly Hills, CA
  • NPI 1205253929
  Medicare reassignment NPD
• County of Los Angeles

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1649345760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE 600",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104232",
            "telephone_number": "310-651-2280",
            "fax_number": "310-651-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 N ROXBURY DR",
            "address_2": "SUITE 600",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104232",
            "telephone_number": "310-651-2280",
            "fax_number": "310-651-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSON-HEREDIA",
        "first_name": "CARRIE",
        "middle_name": "DENISE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NURSE",
            "identifier": "508419",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCNA CERTIFICATION",
            "identifier": "074093",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE ANESTHETIST",
            "identifier": "3288",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deena Midani, M.D.
• Stewart A Middler, M.D.
• Mary Miglietta-Rothman, DDS
• Marian Mihail
• Victoria Mihich, M.F.T.
• Miko Anesthesia Group
• Miko Surgery Center, Inc.
• Milart Pharmacy Inc
• Miles Madison D D S Inc
• Franklin C Milgrim, MD

• Certified Registered Nurse Anesthetist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.