Individual provider Active NPI

David P Carelock, CRNA

  • Certified Registered Nurse Anesthetist
  • Saint Helena, CA
National Provider Identifier
1790773596
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
NA3375 Issued in CA
Practice address
10 Woodland Rd
Saint Helena, CA 94574-9554
Phone
(707) 963-3611
Fax
(254) 200-4090
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 637274 TX
Certified Registered Nurse Anesthetist 367500000X NA3375 CA Primary

Addresses

Primary practice location

10 Woodland Rd
Saint Helena, CA 94574-9554

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 3

IdentifierTypeStateIssuer
006844701MedicaidTX
00C073MOtherTXBLUE CROSS BLUE SHIELD
109873101OtherTXFIRSTCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130409000345 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3971516956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Helena HospitalGroup PAC ID 8729059878, 85 clinicians

Practice addresses (Care Compare)

10 Woodland Rd
Saint Helena, CA 94574-9554
Phone (707) 963-3611

6 Woodland Rd
Suite 202
Saint Helena, CA 94574-9501
Phone (707) 968-0670

Hospital & facility affiliations

  • Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013

Merit-based Incentive Payment System (MIPS)

Final score
85.91 of 100Reported as group
Quality
75.49
Promoting interoperability
94
Improvement activities
40
Cost
73.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3375CAMDAudiologist
NA3375CAMDCertified Registered Nurse Anesthetist
637274TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyons Huber Management Nurse Anesthetist, Certified Registered CurrentSince Nov 1, 2021 Accepting new patients
St. Helena Hospital CurrentSince Feb 17, 2013 Accepting new patients
St. Helena Hospital CurrentSince Feb 17, 2013 Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

10 Woodland Rd
Saint Helena, CA 94574
Phone (707) 963-2002

6 Woodland Rd
Ste 202
Saint Helena, CA 94574
Phone (707) 963-5294

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 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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1790773596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WOODLAND RD",
            "city": "SAINT HELENA",
            "state": "CA",
            "postal_code": "945749554",
            "telephone_number": "707-963-3611",
            "fax_number": "254-200-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARELOCK",
        "first_name": "DAVID",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "637274",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "NA3375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006844701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00C073M",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "109873101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Helena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.