Individual provider Active NPI

Alicia Boenish, CRNA, DNAP

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
National Provider Identifier
1750912515
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
124036 Issued in MN
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 386-6000
NPI assigned
Jan 30, 2020
Last updated
Jan 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 124036 MN Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

1220 Center St W
Rochester, MN 55902-0306
Phone (507) 269-0137

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200402002313 WA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799114302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1229 Madison St
Suite 1440
Seattle, WA 98104-3538
Phone (206) 625-0578

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
80.9
Improvement activities
40
Cost
75.66

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
124036MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Washington Medical Group, Inc, PS CurrentSince Apr 1, 2020 Accepting new patients
Physicians Anesthesia Service PLLC Current Accepting new patients
Advanced Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2022 Accepting new patients
Eastside Medical Group, LLC Past Accepting new patients

Locations

1301 4th Ave NW
Ste 201
Issaquah, WA 98027
Phone (425) 270-3713

1145 Broadway
Seattle, WA 98122

1229 Madison St
Ste 1440
Seattle, WA 98104
Phone (206) 625-0578

600 Broadway
Ste 270
Seattle, WA 98122
Phone (206) 381-0269

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

35302 SE Center St
Snoqualmie, WA 98065
Phone (425) 216-8810

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1750912515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CENTER ST W",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559020306",
            "telephone_number": "507-269-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-386-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENISH",
        "first_name": "ALICIA",
        "credential": "CRNA, DNAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MN",
            "license": "124036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; 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.