Individual provider Active NPI

Erica Petruzzi, CRNA

  • Certified Registered Nurse Anesthetist
  • Coudersport, PA
National Provider Identifier
1770711152
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN528454L Issued in PA
Practice address
1001 E 2ND St
Coudersport, PA 16915-8161
Phone
(814) 274-9301
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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 RN528454L PA Primary

Addresses

Primary practice location

1001 E 2ND St
Coudersport, PA 16915-8161

Mailing address

1001 E 2ND St
Coudersport, PA 16915-8161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100121000012 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890837439 Reassigns benefits to 2 organizations
I20190404001848 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890837439 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charles Cole Memorial HospitalGroup PAC ID 3779487475, 66 clinicians

Practice addresses (Care Compare)

1001 E 2ND St
Coudersport, PA 16915-8161

11 8TH St
Coudersport, PA 16915-1207
Phone (814) 274-1111

Hospital & facility affiliations

  • Upmc Cole Hospital, Coudersport, PA, CCN 391313

Merit-based Incentive Payment System (MIPS)

Final score
83.69 of 100Reported as group
Quality
75.14
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN528454LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Anesthesiology, PC CurrentSince Jan 15, 2018 Accepting new patients
Charles Cole Memorial Hospital D/B/a Upmc Cole Past Accepting new patients

Locations

1001 Main St
Ste K3502
Buffalo, NY 14203
Phone (716) 323-6576

3095 Harlem Rd
Cheektowaga, NY 14225
Phone (716) 896-2245

515 Main St
Olean, NY 14760
Phone (716) 373-2600

2 W Crescent Park
Warren, PA 16365
Phone (814) 452-5337

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1770711152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E 2ND ST",
            "city": "COUDERSPORT",
            "state": "PA",
            "postal_code": "169158161",
            "telephone_number": "814-274-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZI",
        "first_name": "ERICA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN528454L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coudersport, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; 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.