Individual provider Active NPI

Bryson Anderson, CRNA

  • Certified Registered Nurse Anesthetist
  • State College, PA
National Provider Identifier
1760954093
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123919 Issued in PA
Practice address
1800 E Park Ave
State College, PA 16803-6709
Phone
(814) 231-7000
NPI assigned
Dec 27, 2018
Last updated
Dec 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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 123919 PA Primary

Addresses

Primary practice location

1800 E Park Ave
State College, PA 16803-6709

Mailing address

111 Oak Pointe Cir
State College, PA 16801-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606001638 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799018719 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Nittany Medical CenterGroup PAC ID 2365353364, 45 clinicians

Practice addresses (Care Compare)

1800 E Park Ave
State College, PA 16803-6797
Phone (814) 231-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123919PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Nittany Medical Center CurrentSince Apr 17, 2019 Accepting new patients
Remcare Anesthesia Solutions LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 10, 2024 Accepting new patients
Mount Nittany Medical Center Nurse Anesthetist, Certified Registered CurrentSince Apr 17, 2019 Accepting new patients

Locations

3280 Pleasant Valley Blvd
Altoona, PA 16602
Phone (814) 381-0009

176 Vision Dr
Duncansville, PA 16635
Phone (814) 949-1914

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

1850 E Park Ave
State College, PA 16803
Phone (814) 234-6750

Organizations & group practices 3

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": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1760954093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAK POINTE CIR",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168018600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E PARK AVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036709",
            "telephone_number": "814-231-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRYSON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "123919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.