Individual provider Active NPI

Brandon Keith Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Elkhart, IN
National Provider Identifier
1659654978
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
87705 Issued in IN
Practice address
600 East Blvd
Elkhart, IN 46514-2483
Phone
(574) 523-3193
NPI assigned
Sep 22, 2011
Last updated
Sep 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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 87705 IN Primary

Addresses

Primary practice location

600 East Blvd
Elkhart, IN 46514-2483

Mailing address

20084 Stone Creek Dr
Goshen, IN 46528-6114
Phone (801) 518-3054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150520001365 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476725367 Reassigns benefits to 2 organizations
I20191220000839 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3476725367 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excelle Anesthesia Services IncGroup PAC ID 4688046774, 41 clinicians
Coachella Valley Anesthesia a Professional CorporationGroup PAC ID 5698131969, 126 clinicians

Practice addresses (Care Compare)

2215 Truxtun Ave
Bakersfield, CA 93301-3602
Phone (661) 632-5504

420 34TH St
Bakersfield, CA 93301-2237
Phone (661) 324-4647

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95001151CAMDFamily Nurse Practitioner
87705INMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Coachella Valley Anesthesia a Professional Corporation Nurse Anesthetist, Certified Registered CurrentSince Dec 15, 2024 Accepting new patients
Comfort Anesthesia Associates Inc CurrentSince Jan 1, 2021 Accepting new patients
Anesthesia Partners & Management LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2018 Accepting new patients
MVG Anesthesia Inc a Professional Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Sep 10, 2023 Accepting new patients
Northeastern Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2015 Accepting new patients
Garrett S Hilt Certified Registered Nursing Anesthesia Inc CurrentSince May 30, 2020 Accepting new patients
Valley Regional Anesthesia Associates Inc CurrentSince Oct 7, 2023 Accepting new patients
Excelle Anesthesia Services, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Valley Anesthesia Associates, Inc. CurrentSince Oct 19, 2019 Accepting new patients
Great Lakes Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Great Lakes Anesthesia Indiana and Michigan, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 26)

1020 N San Francisco St
Ste 100
Flagstaff, AZ 86001
Phone (928) 774-2300

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

3900 E Camelback Rd
Ste 190
Phoenix, AZ 85018
Phone (888) 724-6236

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

3110 Clearwater Dr
Prescott, AZ 86305
Phone (623) 241-6185

5430 Distinction Way
Prescott, AZ 86301
Phone (928) 445-1919

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

1704 W Anklam Rd
Ste 108
Tucson, AZ 85745
Phone (623) 241-6185

860 Oak Park Blvd
Ste 102
Arroyo Grande, CA 93420
Phone (805) 458-8661

2215 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 477-9283

2615 Chester Ave
Bakersfield, CA 93301
Phone (661) 381-7545

2635 G St
Bakersfield, CA 93301
Phone (661) 633-1500

3001 Sillect Ave
Bakersfield, CA 93308
Phone (661) 316-6000

400 Old River Rd
Bakersfield, CA 93311
Phone (661) 663-6000

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

4500 Morning Dr
Ste 102
Bakersfield, CA 93306
Phone (661) 437-4140

700 W El Norte Pkwy
Escondido, CA 92026
Phone (760) 738-7830

115 Mall Dr
Hanford, CA 93230
Phone (559) 537-0550

6601 White Feather Rd
Joshua Tree, CA 92252
Phone (760) 366-1500

145 Trevino Ave
Manteca, CA 95337
Phone (209) 788-8180

1300 Mable Ave
Ste 1
Modesto, CA 95355
Phone (209) 571-1633

44139 Monterey Ave
Ste B
Palm Desert, CA 92260
Phone (760) 773-4411

1150 N Indian Canyon Dr
Palm Springs, CA 92262
Phone (760) 323-6251

465 W Putnam Ave
Porterville, CA 93257
Phone (559) 784-8886

2900 Eureka Way
Redding, CA 96001
Phone (530) 225-8700

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.

Hospital & facility affiliations 3

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": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1659654978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20084 STONE CREEK DR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465286114",
            "telephone_number": "801-518-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRANDON",
        "middle_name": "KEITH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-22",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "87705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.