Individual provider Active NPI

Bermon Wren Reyes Punzalan, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • McHenry, IL
National Provider Identifier
1700774734
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209033305 Issued in IL
Practice address
4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone
(815) 344-5000
Fax
(815) 344-3347
NPI assigned
Jun 26, 2025
Last updated
Feb 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95002704 CA
Certified Registered Nurse Anesthetist 367500000X 209033305 IL Primary
Registered Nurse 163W00000X 95196322 CA

Addresses

Primary practice location

4201 W Medical Center Dr
McHenry, IL 60050-8409

Mailing address

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251117002628 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981195062 Reassigns benefits to 3 organizations
I20260109003319 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4981195062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HP Anesthesia IncGroup PAC ID 6608009766, 34 clinicians
Socal Anesthesia Solutions IncGroup PAC ID 0042607426, 46 clinicians
Credence Anesthesia CorporationGroup PAC ID 9133586639, 12 clinicians

Practice addresses (Care Compare)

1300 N Vermont Ave
Los Angeles, CA 90027-6098
Phone (213) 413-3000

1401 S Grand Ave
Los Angeles, CA 90015-3010
Phone (213) 742-5910

18575 Gale Ave
Suite 198
City of Industry, CA 91748-1382
Phone (626) 965-3880

4309 W Medical Ctr Dr
Suite A200
McHenry, IL 60050-8437
Phone (815) 759-8070

515 Valley View Dr
Suite 201
Moline, IL 61265-6175
Phone (312) 695-0870

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95196322CAMDRegistered Nurse
209033305ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 5, 2026 Accepting new patients
Socal Anesthesia Solutions, Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 5, 2026 Accepting new patients
Credence Anesthesia Corporation Nurse Anesthetist, Certified Registered CurrentSince Sep 24, 2025 Accepting new patients
HP Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 16, 2025 Accepting new patients
West Coast Surgery Inc Past Accepting new patients

Locations

1000 S Anaheim Blvd
Ste 300
Anaheim, CA 92805
Phone (714) 221-2196

18575 Gale Ave
Ste 198
City of Industry, CA 91748
Phone (626) 656-1285

12017 Paramount Blvd
Downey, CA 90242
Phone (562) 381-2494

1300 N Vermont Ave
Los Angeles, CA 90027
Phone (213) 413-3000

1401 S Grand Ave
Los Angeles, CA 90015
Phone (213) 742-5555

2000 Outlet Center Dr
Oxnard, CA 93036
Phone (805) 643-3332

36915 Cook St
Ste 103B
Palm Desert, CA 92211
Phone (760) 340-1003

815 Auto Center Dr
Palmdale, CA 93551
Phone (661) 206-6262

7640 Tampa Ave
Ste 102
Reseda, CA 91335
Phone (818) 674-4888

5651 Sepulveda Blvd
Ste 101
Van Nuys, CA 91411
Phone (818) 442-9696

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6100

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

4201 W Medical Center Dr
McHenry, IL 60050
Phone (815) 759-3100

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 6

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": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1700774734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNZALAN",
        "first_name": "BERMON WREN",
        "middle_name": "REYES",
        "credential": "APRN, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-26",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95002704",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209033305",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95196322",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.