Individual provider Active NPI

Walross Jim Basit, CRNA

  • Certified Registered Nurse Anesthetist
  • Lincoln, NE
National Provider Identifier
1699123976
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
110041 Issued in NE
Practice address
4544 Bancroft Ave Apt 4
Lincoln, NE 68506-4272
Phone
(817) 454-3018
NPI assigned
May 27, 2016
Last updated
May 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2016

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 110041 NE Primary

Addresses

Primary practice location

4544 Bancroft Ave Apt 4
Lincoln, NE 68506-4272

Mailing address

4544 Bancroft Ave Apt 4
Lincoln, NE 68506-4272
Phone (817) 454-3018

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160718000526 NE Practitioner - Certified Registered Nurse Anesthetist (Crna) 6406148170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

555 S 70TH St
CHI Health St. Elizabeth
Lincoln, NE 68510-2462
Phone (402) 219-8000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110041NEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2019 Accepting new patients
CHI Health Clinic Physician Enterprise-Anesthesia LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

555 S 70th St
Lincoln, NE 68510
Phone (402) 219-8000

7500 Mercy Rd
Ste 1355
Omaha, NE 68124
Phone (402) 717-4866

Organizations & group practices 2

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 1

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1699123976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4544 BANCROFT AVE APT 4",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064272",
            "telephone_number": "817-454-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4544 BANCROFT AVE APT 4",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685064272",
            "telephone_number": "817-454-3018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASIT",
        "first_name": "WALROSS",
        "middle_name": "JIM",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NE",
            "license": "110041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2016; 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.