Individual provider Active NPI

Cassandra Nicole List

  • Certified Registered Nurse Anesthetist
  • Boynton Beach, FL
National Provider Identifier
1649700907
Registry record updated Jul 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9463521 Issued in FL
Practice address
2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969
Phone
(561) 292-4663
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2017

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 9463521 FL Primary

Addresses

Primary practice location

2815 S Seacrest Blvd
Boynton Beach, FL 33435-7969

Mailing address

10968 NW 3Rd St
Coral Springs, FL 33071-8116
Phone (954) 376-1709

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171109000359 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1355607243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians
Port St Lucie Anesthesia LLCGroup PAC ID 2769743343, 4 clinicians

Practice addresses (Care Compare)

10101 Forest Hill Blvd
Wellington, FL 33414-6103
Phone (561) 798-8505

1715 SE Tiffany Ave
Port St Lucie, FL 34952-7511
Phone (772) 335-7005

401 NW 42ND Ave
Plantation, FL 33317-2835
Phone (954) 587-5010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9463521FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Port St Lucie Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 15, 2020 Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 14, 2019 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Sep 13, 2019 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 13, 2019 Accepting new patients
Greater Florida Anesthesiologists, LLC Current Accepting new patients
Greater Florida Anesthesiologists, LLC CurrentSince Oct 14, 2019 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

2140 W 68th St
Hialeah, FL 33016
Phone (305) 822-4107

401 NW 42nd Ave
Plantation, FL 33317
Phone (954) 513-6434

1715 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 335-3939

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

7050 Gall Blvd
Zephyrhills, FL 33541
Phone (813) 779-1209

2600 Bruce B Downs Blvd
Zephyrhills, FL 33544
Phone (954) 393-5000

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499212800000",
    "number": "1649700907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10968 NW 3RD ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330718116",
            "telephone_number": "954-376-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 S SEACREST BLVD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357969",
            "telephone_number": "561-292-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIST",
        "first_name": "CASSANDRA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9463521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2017; 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.