Individual provider Active NPI

Elizabeth Marie Wolgemuth, CRNA

  • Certified Registered Nurse Anesthetist
  • St Petersburg, FL
National Provider Identifier
1750080198
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11026192 Issued in FL
Practice address
701 6TH St S
St Petersburg, FL 33701-4814
Phone
(727) 432-3255
NPI assigned
Feb 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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 APRN11026192 FL Primary

Addresses

Primary practice location

701 6TH St S
St Petersburg, FL 33701-4814

Mailing address

2001 63Rd Ave N
St Petersburg, FL 33702-7128
Phone (727) 432-3255

Other identifiers 1

IdentifierTypeStateIssuer
119175300MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818003410 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7214399450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 893-6182

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jan 17, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 17, 2025 Accepting new patients

Locations

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

Organizations & group practices 2

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 1

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": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1750080198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 63RD AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337027128",
            "telephone_number": "727-432-3255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014814",
            "telephone_number": "727-432-3255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLGEMUTH",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11026192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119175300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; 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.