Individual provider Active NPI

Wayne Francis Wilbur, CRNA

  • Certified Registered Nurse Anesthetist
  • Nantucket, MA
National Provider Identifier
1649359548
Registry record updated Feb 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
199070 Issued in MA
Practice address
57 Prospect St
Nantucket, MA 02554-2799
Phone
(774) 563-1876
Fax
(401) 826-0410
NPI assigned
Nov 3, 2006
Last updated
Feb 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 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 199070 MA Primary

Addresses

Primary practice location

57 Prospect St
Nantucket, MA 02554-2799

Mailing address

57 Prospect St
Nantucket, MA 02554-2799
Phone (774) 563-1876

Other identifiers 3

IdentifierTypeStateIssuer
P00214045OtherRAILRAOD
NA1102OtherMABCBS
1649359548OtherFALLON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050223000519 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719930304 Reassigns benefits to 4 organizations
I20100105000599 RI Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719930304 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matrix Anesthesia PCGroup PAC ID 8820136377, 52 clinicians

Practice addresses (Care Compare)

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
199070MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 6, 2023 Accepting new patients
Anesthesia Partners of New England, LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 30, 2024 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Mar 15, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 6, 2023 Accepting new patients
Icon Anesthesia Services of New England LLC CurrentSince Jul 20, 2024 Accepting new patients
Anesthesia Professionals, Inc. Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
Matrix Anesthesia, PC CurrentSince Oct 1, 2022 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Mar 15, 2023 Accepting new patients
Northern Rhode Island Anesthesia Associates, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthetics of Massachusetts, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

138 Haverhill St
Andover, MA 01810
Phone (978) 296-2302

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

748 Mount Pleasant St
Unit 50036
New Bedford, MA 02745

500 Faunce Corner Rd
Ste 180
North Dartmouth, MA 02747
Phone (508) 717-0270

51 State Rd
North Dartmouth, MA 02747
Phone (508) 994-1400

146 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 833-6000

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

400 10th St E
Waconia, MN 55387

100 Highland Ave
Ste 100
Providence, RI 02906
Phone (401) 277-9729

62 Amaral St
Riverside, RI 02915
Phone (401) 649-4030

444 Quaker Ln
Warwick, RI 02886
Phone (401) 935-1439

444 Quaker Ln
Unit 2
Warwick, RI 02886

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267315200000",
    "number": "1649359548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "774-563-1876",
            "fax_number": "401-826-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PROSPECT ST",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "025542799",
            "telephone_number": "774-563-1876",
            "fax_number": "401-826-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBUR",
        "first_name": "WAYNE",
        "middle_name": "FRANCIS",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2010-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "199070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD",
            "identifier": "P00214045",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NA1102",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1649359548",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nantucket, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.