Individual provider Active NPI

Michael A Dagley, CRNA

  • Certified Registered Nurse Anesthetist
  • Heber City, UT
National Provider Identifier
1699790113
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
049473 Issued in AZ
Practice address
1485 S Highway 40
Heber City, UT 84032-3522
Phone
(435) 654-2500
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 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 049473 AZ Primary

Addresses

Primary practice location

1485 S Highway 40
Heber City, UT 84032-3522

Mailing address

1089 E 270 N
Heber City, UT 84032-3051
Phone (435) 654-0361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040114000239 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254232283 Reassigns benefits to 1 organization
I20040217000206 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254232283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Anesthesia LLCGroup PAC ID 9234438649, 4 clinicians

Practice addresses (Care Compare)

454 E Medical Way
Heber City, UT 84032-1391
Phone (435) 654-2500

501 N Navajo
Page, AZ 86040
Phone (928) 645-2424

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.7 of 100Reported as group
Quality
64.97
Promoting interoperability
98
Improvement activities
40
Cost
69.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
049473AZMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Anesthesia LLC Anesthesiology CurrentSince May 1, 2016 Accepting new patients
Page Hospital CurrentSince Dec 1, 2016 Accepting new patients
Page Hospital CurrentSince Dec 1, 2016 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince Sep 1, 2012 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Resource Anesthesia, P.C. Nurse Anesthetist, Certified Registered Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Verde Valley Medical Center Past Accepting new patients

Locations

454 E Medical Way
Heber City, UT 84032
Phone (435) 654-2500

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1699790113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1089 E 270 N",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323051",
            "telephone_number": "435-654-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 S HIGHWAY 40",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840323522",
            "telephone_number": "435-654-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGLEY",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "049473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.