Samuel Bergener, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

63318 Issued in NM

Practice address

801 W Maple St
Farmington, NM 87401-5630

Phone

(505) 609-2000

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID, TX, NM3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Kansas School of Med (KC/Wich/Sal), 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

San Juan Regional Medical Center, Inc.Group PAC ID 4587559505, 233 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005
• Memorial Medical Center Hospital, Las Cruces, NM, CCN 320018

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• San Juan Regional Medical Center Inc

  • Gastroenterology Physician
  • Farmington, NM
  • NPI 1639662901
  Medicare reassignment Care Compare group NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• Intermountain Anesthesia, PA

  • Anesthesiology Physician
  • Idaho Falls, ID
  • NPI 1558304329

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment NPD
• Main Street Anesthesia of New Mexico, LLC

  • Anesthesiology Physician
  • Albuquerque, NM
  • NPI 1275010985
  Care Compare group
• San Juan Regional Medical Center Inc

  • Emergency Medicine Physician
  • Farmington, NM
  • NPI 1518932151
  NPD
• San Juan Regional Medical Center Inc

  • Family Medicine Physician
  • Farmington, NM
  • NPI 1710589015
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teecnospos, AZ
  • NPI 1477615789
  NPD
• San Juan Regional Medical Center Inc

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1639459712
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• PHC-Las Cruces Inc

  • General Acute Care Hospital
  • Las Cruces, NM
  • NPI 1700821808
  Care Compare affiliation
• San Juan Regional Medical Center Inc

  • Rehabilitation Hospital Unit
  • Farmington, NM
  • NPI 1326663592
  Care Compare affiliation
• San Juan Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Farmington, NM
  • NPI 1427058510
  Care Compare affiliation

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1780724419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015630",
            "telephone_number": "505-609-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11511 NE 10th St",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980048578",
            "country_code": "US",
            "telephone_number": "425-502-3000",
            "fax_number": "425-502-3589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERGENER",
        "first_name": "SAMUEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "MB2468470",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "63318",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "N-26821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Laura Bennett, RN
• Bentley Chiropractic, PC
• Robert T Bentley, DC
• Tisa Bernally-Russell, BSW, LSAA
• Stephen Thomas Bernard, M.D.
• Anita Berryhill
• Better Together Home and Community Services, LLC
• Mark Bevan, M.D.

• Certified Registered Nurse Anesthetist in Farmington, NM
• Providers in Farmington, NM by specialty
• Certified Registered Nurse Anesthetist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.