NPIMap

Individual provider Active NPI

Ellison Pua Concepcion, CRNA MSN

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
National Provider Identifier
1689187858
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95000804 Issued in CA
Practice address
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone
(323) 857-2000
NPI assigned
Nov 9, 2017
Last updated
Dec 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

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 95000804 CA Primary

Addresses

Primary practice location

6041 Cadillac Ave
Los Angeles, CA 90034-1702

Mailing address

6041 Cadillac Ave
Los Angeles, CA 90034-1702

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190605003164 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739412719 Reassigns benefits to 6 organizations
I20241212002837 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 9739412719 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
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (651) 262-7633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
95000804CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Apr 11, 2019 Accepting new patients
Advanced Anesthesia Specialists a Medical Corporation CurrentSince Oct 21, 2022 Accepting new patients
Twin Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Allina Health System Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Apr 11, 2019 Accepting new patients
Ellison Concepcion Nursing Anesthesiology Services Inc Nurse Anesthetist, Certified Registered CurrentSince Mar 12, 2024 Accepting new patients
Metropolitan Anesthesia Network, LLP Nurse Anesthetist, Certified Registered CurrentSince Dec 3, 2024 Accepting new patients
Axiom Anesthesia a Professional Nursing Corporation CurrentSince Nov 2, 2022 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Advanced Anesthesia Specialists a Medical Corporation CurrentSince Oct 21, 2022 Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients
Northridge Pain Management Specialists Medical Corporation CurrentSince Oct 3, 2023 Accepting new patients
Allina Health System CurrentSince Jan 27, 2025 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

8331 Reseda Blvd
Northridge, CA 91324
Phone (818) 724-5979

13652 Cantara St
Panorama City, CA 91402
Phone (818) 375-2417

2811 Wilshire Blvd
Ste 690
Santa Monica, CA 90403
Phone (310) 828-7239

430 E Avenida de los Arboles
Ste 101
Thousand Oaks, CA 91360
Phone (805) 241-0151

7230 Medical Ctr
Ste 500
West Hills, CA 91307
Phone (310) 285-2424

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

310 Smith Ave N
Ste 100
Saint Paul, MN 55102
Phone (651) 251-5500

400 10th St E
Waconia, MN 55387

1050 Wall St W
Ste 360
Lyndhurst, NJ 07071
Phone (201) 821-7900

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1689187858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6041 CADILLAC AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900341702",
            "telephone_number": "323-857-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "ELLISON",
        "middle_name": "PUA",
        "credential": "CRNA MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-09",
        "last_updated": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95000804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.