Brian R. Knopp, CRNA, BSN, MSN
Individual provider Active NPI Certified Registered Nurse Anesthetist · Omak, WA
NPI 1649680620 · NPPES record last updated Apr 30, 2014
Key facts
- NPI
- 1649680620
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- AP60451290 (WA)
- Practice address
- 810 Jasmine St
Omak, WA 98841 - Phone
- (509) 826-1750
- NPI assigned
- Apr 30, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anesthesia Management Services of California Inc
Koolau Anesthesia Group LLC
Practice addresses (Care Compare)
275 Hospital Dr
Ukiah, CA 95482-4531
Phone (707) 462-3111
640 Ulukahiki St
Kailua, HI 96734-4454
Phone (808) 263-5500
Hospital & facility affiliations
- Adventist Health Ukiah Valley
- Adventist Health Castle
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in HI, CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150728005292 | HI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7618292251 | Reassigns benefits to 2 organizations |
| I20240417001348 | CA | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 7618292251 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Bachelor on Science - Nursing, Certified Registered Nurse, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1904 | HI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Koolau Anesthesia Group, LLC | Current |
Accepting new patients | |
| Pec Anesthesia LLC | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| Anesthesia Management Services of California Inc | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
Locations
275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900
1401 S Beretania St
Ste 200
Honolulu, HI 96814
Phone (808) 312-6700
640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326
642 Ulukahiki St
Ste 200
Kailua, HI 96734
Phone (808) 218-6850
1029 Makolu St
Ste H
Pearl City, HI 96782
Phone (808) 456-6420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AP60451290 | WA | Yes |
Addresses
Primary practice location
810 Jasmine St
Omak, WA 98841
Mailing address
PO Box 793
810 Jasmine St
Omak, WA 98841-0793
Phone (509) 826-1760
Other providers in Omak, WA
- Suzanne Kelsey
- Yvonne Rea Kennedy
- Jo Kiester
- Kati Kitterman
- Chelsea Anne Klimek
- Jungryul Koh
- Shirley Kuchta
- Linda Lampman
- Suzanne Linda Larson
- Timothy A Larson
All providers in Omak, WA · Certified Registered Nurse Anesthetist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.