Individual provider Active NPI

Randy R Pomar, CRNA

  • Certified Registered Nurse Anesthetist
  • Zion, IL
National Provider Identifier
1649516410
Registry record updated Dec 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.010072 Issued in IL
Practice address
2520 Elisha Ave
Zion, IL 60099-2676
Phone
(847) 872-6259
NPI assigned
Dec 21, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2012

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 209.010072 IL Primary

Addresses

Primary practice location

2520 Elisha Ave
Zion, IL 60099-2676

Mailing address

2520 Elisha Ave
Zion, IL 60099-2676
Phone (847) 872-6259

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000319 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486894847 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Wayne State University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Anesthesia Associates P CGroup PAC ID 0042118069, 53 clinicians
City of Hope Medical Group of Illinois PLLCGroup PAC ID 3274446596, 129 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

1900 Silver Cross Blvd
New Lenox, IL 60451-9509
Phone (815) 300-1100

2520 Elisha Ave
Zion, IL 60099-2676
Phone (847) 872-4561

403 S Kennedy Dr
Bradley, IL 60915-2152
Phone (815) 928-9999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.5 of 100Reported as group
Quality
74.24
Promoting interoperability
100
Improvement activities
40
Cost
66.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.010072ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Anesthesia Associates, P.C. CurrentSince Aug 13, 2021 Accepting new patients
City of Hope Medical Group of Illinois PLLC CurrentSince May 18, 2013 Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2025 Accepting new patients
Rockford Anesthesiologists Associated, L.L.C. CurrentSince Apr 15, 2025 Accepting new patients

Locations

403 S Kennedy Dr
Bradley, IL 60915
Phone (815) 928-9999

2361 Paysphere Cir
Chicago, IL 60674
Phone (847) 746-4358

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

1016 Featherstone Rd
Rockford, IL 61107
Phone (815) 226-3300

2520 Elisha Ave
Zion, IL 60099
Phone (800) 322-9183

Organizations & group practices 4

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 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": "1356048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356048000000",
    "number": "1649516410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992676",
            "telephone_number": "847-872-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992676",
            "telephone_number": "847-872-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMAR",
        "first_name": "RANDY",
        "middle_name": "R",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-21",
        "last_updated": "2012-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.010072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2012; 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.