Individual provider Active NPI

Patricia Isabel Calcetto, CRNA

  • Certified Registered Nurse Anesthetist
  • Mount Vernon, IL
National Provider Identifier
1831611334
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209016170 Issued in IL
Practice address
2 Good Samaritan Way
Mount Vernon, IL 62864-2408
Phone
(618) 899-3869
NPI assigned
Jul 17, 2017
Last updated
Jul 17, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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 209016170 IL Primary

Addresses

Primary practice location

2 Good Samaritan Way
Mount Vernon, IL 62864-2408

Mailing address

31 Webster Hill Est
Mount Vernon, IL 62864-2346
Phone (386) 986-0055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170831000637 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 5092088799 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (557) 203-1601

2 Good Samaritan Way
Suite 200
Mount Vernon, IL 62864-2476
Phone (618) 899-3869

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
98.77 of 100Reported as group
Quality
85.58
Promoting interoperability
100
Improvement activities
40
Cost
76.99

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
79.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Southern Illinois Surgery Center LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 23, 2018 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jul 17, 2017 Accepting new patients
Good Samaritan Regional Health Center Current Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jul 17, 2017 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Current Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

2 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 899-4000

2 Good Samaritan Way
Ste 200
Mount Vernon, IL 62864
Phone (618) 899-3869

4225 Lincolnshire Dr
Ste B
Mount Vernon, IL 62864

5 Good Samaritan Way
Mount Vernon, IL 62864
Phone (557) 203-1601

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1831611334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WEBSTER HILL EST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642346",
            "telephone_number": "386-986-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 GOOD SAMARITAN WAY",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642408",
            "telephone_number": "618-899-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALCETTO",
        "first_name": "PATRICIA",
        "middle_name": "ISABEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209016170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.