NPIMap

Organization Active NPI

Firelands Anesthesia Associates, Inc

  • Certified Registered Nurse Anesthetist
  • Willard, OH
National Provider Identifier
1811906340
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
FIRELANDS ANESTHESIA ASSOCIATES, INC
Practice address
704 Kennedy Dr
Willard, OH 44890-9413
Phone
(419) 933-4378
Fax
(419) 935-0890
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Michael J Brasko, C.R.N.A.NPI 1194785360
Title
President
Phone
(918) 543-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X Primary

Addresses

Primary practice location

704 Kennedy Dr
Willard, OH 44890-9413

Mailing address

PO Box 190
Inola, OK 74036-0190
Phone (918) 543-1020

Other identifiers 1

IdentifierTypeStateIssuer
2283783MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050926001020 OH Part B Supplier - Clinic/Group Practice 9032143334 Receives reassigned benefits from 30 practitioners
Practice locations: Willard, OH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 31

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1811906340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "INOLA",
            "state": "OK",
            "postal_code": "740360190",
            "telephone_number": "918-543-1020",
            "fax_number": "866-258-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 KENNEDY DR",
            "city": "WILLARD",
            "state": "OH",
            "postal_code": "448909413",
            "telephone_number": "419-933-4378",
            "fax_number": "419-935-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRELANDS ANESTHESIA ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "BRASKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "918-543-1020",
        "authorized_official_credential": "C.R.N.A."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2283783",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willard, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.