Individual provider Active NPI

John Tran Ly, CRNA

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1811601271
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11023893 Issued in FL
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-5029
NPI assigned
Jan 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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 11023893 FL Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

96091 Roxabogue Dr
Fernandina Beach, FL 32034-8141
Phone (904) 415-1383

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230223001856 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315310224 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Florida Jacksonville Physicians, Inc.Group PAC ID 9133025869, 908 clinicians

Practice addresses (Care Compare)

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-3505

Hospital & facility affiliations

  • Shands Jacksonville Hospital, Jacksonville, FL, CCN 100001

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11023893FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince Feb 27, 2023 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Feb 27, 2023 Accepting new patients
Quiescence Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Current Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

5191 First Coast Tech Pkwy
Fl 1
Jacksonville, FL 32224
Phone (904) 593-5146

1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414

1780 N Mills Ave
Orlando, FL 32803
Phone (407) 426-8484

1879 Nightingale Ln
Ste A1
Tavares, FL 32778
Phone (352) 401-1919

Organizations & group practices 4

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": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1811601271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96091 ROXABOGUE DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348141",
            "telephone_number": "904-415-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-5029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "JOHN",
        "middle_name": "TRAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11023893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.