Individual provider Active NPI

Patrick Joseph Wiltse

  • Certified Registered Nurse Anesthetist
  • Largo, FL
National Provider Identifier
1831803584
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11034719 Issued in FL
Practice address
201 14TH St SW
Largo, FL 33770-3133
Phone
(727) 588-5200
NPI assigned
Jan 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704313517 MI
Certified Registered Nurse Anesthetist 367500000X APRN11034719 FL Primary

Addresses

Primary practice location

201 14TH St SW
Largo, FL 33770-3133

Mailing address

35615 Lone Pine LN
Farmington Hills, MI 48335-5802
Phone (248) 924-0984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022001415 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9133651656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunshine State Anesthesia Partners LLCGroup PAC ID 8123434792, 429 clinicians

Practice addresses (Care Compare)

201 14TH St SW
Largo, FL 33770-3133
Phone (727) 588-5200

Hospital & facility affiliations

  • HCA Florida Largo Hospital Hospital, Largo, FL, CCN 100248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704313517MIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine State Anesthesia Partners LLC CurrentSince Nov 4, 2024 Accepting new patients
University of Detroit Mercy PastSince Jan 1, 2023 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 2

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1831803584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35615 LONE PINE LN",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483355802",
            "telephone_number": "248-924-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 14TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703133",
            "telephone_number": "727-588-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTSE",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704313517",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11034719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.