Gerald Derise, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

573282 Issued in FL

Practice address

325 Avenue B NW
Winter Haven, FL 33881-4651

Phone

(863) 291-4000

NPI assigned

May 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Mobile Anesthesia Associates LLC

  • Pain Medicine (Anesthesiology) Physician
  • Stuart, FL
  • NPI 1295776243
  NPD (past)
• Reza Yasrebi, MD, PA

  • Pain Medicine (Anesthesiology) Physician
  • Lakeland, FL
  • NPI 1801995519
  NPD (past)
• Southwest Florida Anesthesia Plus

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1154370013

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1720025935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 917110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328917110",
            "telephone_number": "800-901-2102",
            "fax_number": "423-892-5838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 AVENUE B NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814651",
            "telephone_number": "863-291-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERISE",
        "first_name": "GERALD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "573282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00274577",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306429800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD FL",
            "identifier": "G0579",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamie-Anne Dennis
• Dental Associates of Florida (Winter Haven) PLLC
• Dental Solutions of Winter Haven
• Dental View, LLC
• Maria Eloisa Depadua, MD
• Kentoiya Monish Deshazer, RN
• Wendy Deshommes
• Designed for Greatness LLC
• Designed for Greatness LLC
• Christy Despain, DPT

• Certified Registered Nurse Anesthetist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.