Michael David Monfore, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · York, NE
NPI 1699788018 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1699788018
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 100656 (NE)
- Practice address
- 2222 N Lincoln Ave
York, NE 68467-1030 - Phone
- (402) 362-6671
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1997
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Fillmore County Hospital
York General Hospital
Practice addresses (Care Compare)
1900 F St
Geneva, NE 68361-2229
Phone (402) 759-3167
2222 N Lincoln Ave
York, NE 68467-1030
Phone (402) 362-6671
Hospital & facility affiliations
- Annie Jeffrey Memorial County Health Center
- York General Health Care Services
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050301000700 | NE | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 2860445962 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100656 | NE | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| York General Hospital | Nurse Anesthetist, Certified Registered | Current |
Accepting new patients |
| York General Hospital | Current |
Accepting new patients | |
| Fillmore County Hospital | Current |
Accepting new patients | |
| Fillmore County Hospital | Current | Accepting new patients | |
| York General Hospital | Current |
Accepting new patients | |
| Warren Memorial Hospital | Past | Accepting new patients | |
| Kearney Anesthesia Associates PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Warren Memorial Hospital | Past | Accepting new patients |
Locations
1900 F St
Geneva, NE 68361
Phone (402) 759-3167
300 N Columbia Ave
Seward, NE 68434
Phone (402) 643-2971
2222 N Lincoln Ave
York, NE 68467
Phone (402) 362-0420
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 100656 | NE | Yes |
Addresses
Primary practice location
2222 N Lincoln Ave
York, NE 68467-1030
Mailing address
1017 Road O
York, NE 68467-7502
Phone (402) 362-1115
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NE100656 | Medicaid | NE |
NPI Registry JSON
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699788018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1017 ROAD O",
"city": "YORK",
"state": "NE",
"postal_code": "684677502",
"telephone_number": "402-362-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 N LINCOLN AVE",
"city": "YORK",
"state": "NE",
"postal_code": "684671030",
"telephone_number": "402-362-6671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONFORE",
"first_name": "MICHAEL",
"middle_name": "DAVID",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NE",
"license": "100656",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NE100656",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in York, NE
- Kiley Meade
- Logan Meisinger
- Trey Steven Menagh
- Miller Seed and Supply
- Laura Lee Miller
- Matthew Carl Montgomery
- Charles Leon Moore
- Celeste Carolina Morales de Eurek
- Mosaic
- Muriel'S Home Inc.
All providers in York, NE · Certified Registered Nurse Anesthetist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.