Eugene Ellis, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

NA3473 Issued in CA

Practice address

5801 North Canyon Rd
Suite 230
San Ramon, CA 94583-5440

Phone

(925) 275-9910

Fax

(925) 275-9823

NPI assigned

Mar 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, MN2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Abbott Northwestern Hospital Hospital, Minneapolis, MN, CCN 240057

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Allina Health System

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1689606196
  NPD
• Allina Health System

  • Certified Registered Nurse Anesthetist
  • Cambridge, MN
  • NPI 1922402718

  Nurse Anesthetist, Certified Registered

  NPD
• Allina Health System

  • Rheumatology Physician
  • Coon Rapids, MN
  • NPI 1952146516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Allina Health System

  • Obstetrics & Gynecology Physician
  • Edina, MN
  • NPI 1033365853

  Hospital

  Care Compare affiliation
• Allina Health System

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1053354506

  Hospital

  Care Compare affiliation
• Allina Health System

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1053354985

  Hospital

  Care Compare affiliation
• Allina Health System

  • Cardiovascular Disease Physician
  • Minneapolis, MN
  • NPI 1104050160

  Hospital

  Care Compare affiliation
• Allina Health System

  • Neurological Surgery Physician
  • Minneapolis, MN
  • NPI 1144264540

  Hospital

  Care Compare affiliation
• Allina Health System

  • Obesity Medicine (Family Medicine) Physician
  • Minneapolis, MN
  • NPI 1154684835

  Hospital

  Care Compare affiliation
• Allina Health System

  • Ophthalmology Physician
  • Minneapolis, MN
  • NPI 1174567184

  Hospital

  Care Compare affiliation
• Allina Health System

  • Physical Medicine & Rehabilitation Physician
  • Minneapolis, MN
  • NPI 1275577215

  Hospital

  Care Compare affiliation
• Allina Health System

  • Family Medicine Physician
  • Plymouth, MN
  • NPI 1326463845

  Hospital

  Care Compare affiliation
• Allina Health System

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1336185651

  Hospital

  Care Compare affiliation
• Allina Health System

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1346282563

  Hospital

  Care Compare affiliation
• Allina Health System

  • Internal Medicine Physician
  • Minneapolis, MN
  • NPI 1407893936

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1740311513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 HOLLOWAY AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941322664",
            "telephone_number": "415-867-0177",
            "fax_number": "415-867-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NORTH CANYON RD",
            "address_2": "SUITE 230",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945835440",
            "telephone_number": "925-275-9910",
            "fax_number": "925-275-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "3473",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN4261510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "NA0034730",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Kay Ehrlich, L.M.F.T.
• Maryam T Eid
• Maisaa A Eissa-Asaad, CT
• Ammal M Elbehesi
• Elena Gorrow Licensed Clinical Social Worker, Inc.
• Marco Ellison
• Rania Elmouhtaj
• Nila Elumalai
• Dylan Embernate
• Empire Anesthesia Inc

• Certified Registered Nurse Anesthetist in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.