Individual provider Active NPI

Brandon Pankuch

  • Certified Registered Nurse Anesthetist
  • Akron, OH
National Provider Identifier
1740941806
Registry record updated Dec 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
403937 Issued in OH
Practice address
525 E Market St
Akron, OH 44304-1619
Phone
(330) 375-3000
NPI assigned
Dec 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2021

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 403937 OH Primary

Addresses

Primary practice location

525 E Market St
Akron, OH 44304-1619

Mailing address

8104 Ivandale Dr
Parma, OH 44129-4312
Phone (440) 781-1743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220210002634 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2163815341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Anesthesia and Pain Services LLCGroup PAC ID 8022245372, 217 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619
Phone (330) 375-3000

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
403937OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

444 N Main St
Akron, OH 44310
Phone (330) 375-6363

155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

195 Wadsworth Rd
Wadsworth, OH 44281
Phone (330) 331-1000

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

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.

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": "1640908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640908800000",
    "number": "1740941806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8104 IVANDALE DR",
            "city": "PARMA",
            "state": "OH",
            "postal_code": "441294312",
            "telephone_number": "440-781-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 E MARKET ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041619",
            "telephone_number": "330-375-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKUCH",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-31",
        "last_updated": "2021-12-31",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "403937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.