Active NPI
Brandon D Black, CRNA
- Certified Registered Nurse Anesthetist
- Stoughton, MA
National Provider Identifier
1740509355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 2263659
- Practice address
- 255 Plain Drive
C/O Ma Anesthesia Corp.
Stoughton, MA 02072 - Phone
- (617) 523-7900
- NPI assigned
- May 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 2263659 | MA | Primary |
Addresses
Primary practice location
255 Plain Drive
C/O Ma Anesthesia Corp.
Stoughton, MA 02072
Mailing address
PO Box 372
Massachusetts Anesthesia Corp.
Stoughton, MA 02072
Phone (646) 415-3838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2263659 | MA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts Eye and Ear Associates, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Providence, RI
- NPI 1598160095
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423785600000",
"number": "1740509355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 372",
"address_2": "MASSACHUSETTS ANESTHESIA CORP.",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "02072",
"telephone_number": "646-415-3838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PLAIN DRIVE",
"address_2": "C/O MA ANESTHESIA CORP.",
"city": "STOUGHTON",
"state": "MA",
"postal_code": "02072",
"telephone_number": "617-523-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "BRANDON",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-21",
"last_updated": "2015-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "2263659",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.