Individual provider Active NPI

Gabriel Restrepo, CRNA

  • Certified Registered Nurse Anesthetist
  • Salisbury, MD
National Provider Identifier
1831513175
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R197720 Issued in MD
Practice address
100 E Carroll Street
Salisbury, MD 21801
Phone
(410) 543-7375
NPI assigned
Feb 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R197720 MD
Certified Registered Nurse Anesthetist 367500000X 0024175213 VA
Certified Registered Nurse Anesthetist 367500000X R197720 MD Primary

Addresses

Primary practice location

100 E Carroll Street
Salisbury, MD 21801

Mailing address

1613 N. Harrison Parkway
Suite 200, Mailstop SH-9a
Sunrise, FL 33323-2896
Phone (954) 838-2371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171017001981 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628291093 Reassigns benefits to 2 organizations
I20260622001960 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628291093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology of Virginia PCGroup PAC ID 6800790023, 514 clinicians

Practice addresses (Care Compare)

19455 Deerfield Ave
Suite 204
Leesburg, VA 20176-8102
Phone (703) 724-9950

200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone (804) 765-5000

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R197720MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of Virginia, PC CurrentSince Aug 1, 2022 Accepting new patients
CMH Physician Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2018 Accepting new patients
American Anesthesiology of Virginia PC CurrentSince Aug 1, 2022 Accepting new patients
CMH Physician Services, LLC CurrentSince Aug 1, 2018 Accepting new patients

Locations

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273

1755 N Mecklenburg Ave
South Hill, VA 23950
Phone (434) 584-5412

125 Buena Vista Cir
South Hill, VA 23970
Phone (434) 774-2400

Organizations & group practices 5

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": "1391644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1831513175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N. HARRISON PARKWAY",
            "address_2": "SUITE 200, MAILSTOP SH-9A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL STREET",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21801",
            "telephone_number": "410-543-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESTREPO",
        "first_name": "GABRIEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-06",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R197720",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024175213",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R197720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.