Active NPI
Samuel Lecates, CRNA
- Certified Registered Nurse Anesthetist
- Forest, VA
National Provider Identifier
1790788396
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 151711
- Practice address
- 1834 Graves Mill Rd
Forest, VA 24551 - Phone
- (800) 277-8151
- Fax
- (336) 841-6217
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 110650 | NC | |
| Certified Registered Nurse Anesthetist | 367500000X | 151711 | VA | Primary |
Addresses
Primary practice location
1834 Graves Mill Rd
Forest, VA 24551
Mailing address
PO Box 14489
Archdale, NC 27263-7489
Phone (800) 277-8151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010029601 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, VA, GA, NC
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2109 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3571
Phone (910) 486-8880
Merit-based Incentive Payment System (MIPS)
- Final score
- 73.38 of 100
- Quality
- 77.5
- Improvement activities
- 20
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3318 | SC | MD | Chiropractor |
| 466 | NC | MD | Acupuncturist |
| 110650 | NC | MD | Certified Registered Nurse Anesthetist |
| 151711 | VA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Anesthesia Providers, PC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Surgery Center of Central Virginia Inc. | Past | Accepting new patients | |
| Medical Anesthesia and Pain Management Consultants, P.a. | Past | Accepting new patients | |
| LJP Anesthesia Services, PLLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Certified Registered Nurse Anesthetist
- Forest, VA
- NPI 1609833474
GA, NC, SC
-
- Certified Registered Nurse Anesthetist
- Williamsburg, VA
- NPI 1073807376
NC
-
- Ambulatory Surgical Clinic/Center
- Forest, VA
- NPI 1215957816
-
- Certified Registered Nurse Anesthetist
- High Point, NC
- NPI 1396083820
Nurse Anesthetist, Certified Registered
-
- Anesthesiology Physician
- Ft Myers, FL
- NPI 1619966694
-
- Certified Registered Nurse Anesthetist
- Shavertown, PA
- NPI 1578542403
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249344000000",
"number": "1790788396",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 14489",
"city": "ARCHDALE",
"state": "NC",
"postal_code": "272637489",
"telephone_number": "800-277-8151",
"fax_number": "336-841-6217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1834 GRAVES MILL RD",
"city": "FOREST",
"state": "VA",
"postal_code": "24551",
"telephone_number": "800-277-8151",
"fax_number": "336-841-6217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LECATES",
"first_name": "SAMUEL",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2009-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "110650",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "VA",
"license": "151711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010029601",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Forest, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.