Individual provider Active NPI

Dustyn W. Auckerman, CRNA

  • Certified Registered Nurse Anesthetist
  • Bellefontaine, OH
National Provider Identifier
1801103452
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.11865 Issued in OH
Practice address
205 E Palmer Rd
Bellefontaine, OH 43311
Phone
(937) 592-4015
Fax
(937) 292-7148
NPI assigned
Sep 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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 RN301597 OH
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.11865 OH Primary

Addresses

Primary practice location

205 E Palmer Rd
Bellefontaine, OH 43311

Mailing address

205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone (937) 592-4015

Other identifiers 1

IdentifierTypeStateIssuer
3123453MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101025000854 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810180668 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Anesthesia Billing, LLCGroup PAC ID 2264958412, 241 clinicians
Arlington Anesthesia Partners LLCGroup PAC ID 7618344698, 91 clinicians
Mary Rutan HospitalGroup PAC ID 9032013792, 90 clinicians

Practice addresses (Care Compare)

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-8000

205 E Palmer Rd
Bellefontaine, OH 43311-2281
Phone (937) 592-4015

2400 Miami Valley Dr
Dayton, OH 45459-4774
Phone (937) 438-2400

Hospital & facility affiliations

  • Upper Valley Medical Center Hospital, Troy, OH, CCN 360174
  • Springfield Regional Medical Center Hospital, Springfield, OH, CCN 360086
  • Atrium Medical Center Hospital, Franklin, OH, CCN 360076
  • Mary Rutan Hospital Hospital, Bellefontaine, OH, CCN 360197
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CRNA.11865OHMDCertified Registered Nurse Anesthetist
RN301597OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Rutan Hospital CurrentSince Jun 5, 2018 Accepting new patients
Arlington Anesthesia Partners LLC CurrentSince Apr 12, 2025 Accepting new patients
Mary Rutan Hospital CurrentSince Jun 5, 2018 Accepting new patients
Northstar Anesthesia of Ohio LLC CurrentSince Sep 24, 2010 Accepting new patients
PHS Anesthesia Billing, LLC CurrentSince Aug 1, 2025 Accepting new patients
Southwest Ohio Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2022 Accepting new patients
Mary Rutan Hospital Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

205 E Palmer Rd
Bellefontaine, OH 43311
Phone (937) 592-4015

7500 State Rd
Cincinnati, OH 45255
Phone (513) 624-4034

600 N Pickaway St
Circleville, OH 43113
Phone (614) 352-6479

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

3000 Mack Rd
Hamilton, OH 45014
Phone (513) 870-7000

2615 E High St
Springfield, OH 45505
Phone (888) 861-3994

Organizations & group practices 8

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 6

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": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1801103452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E PALMER RD",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433112281",
            "telephone_number": "937-592-4015",
            "fax_number": "937-292-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E PALMER RD",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "43311",
            "telephone_number": "937-592-4015",
            "fax_number": "937-292-7148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUCKERMAN",
        "first_name": "DUSTYN",
        "middle_name": "W.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-02",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "RN301597",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.11865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3123453",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.