Nikolas Shane Wahl, DNAP, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

84604 Issued in NM

Practice address

8401 Pan American Fwy NE Unit 156a
Albuquerque, NM 87113-1824

Phone

(405) 420-2219

NPI assigned

Apr 2, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Main Street Anesthesia of New Mexico, LLCGroup PAC ID 3476807538, 228 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
• Lovelace Women's Hospital Hospital, Albuquerque, NM, CCN 320017
• Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Main Street Anesthesia of New Mexico, LLC

  • Anesthesiology Physician
  • Albuquerque, NM
  • NPI 1275010985

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Westside Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1649373887
  Care Compare affiliation
• Lovelace Health System, LLC

  dba Lovelace Women's Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1982799375
  Care Compare affiliation

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

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1871397422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 N MINGO RD TRLR 106",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741165639",
            "telephone_number": "405-420-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 PAN AMERICAN FWY NE UNIT 156A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131824",
            "telephone_number": "405-420-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "NIKOLAS",
        "middle_name": "SHANE",
        "credential": "DNAP, CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0128863",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NM",
            "license": "84604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Susan Wagoner-Ford, MSW, LISW
• David Milad Sadek Wahba, M.B.B.CH
• Norma Wahba, MD
• Heidi Elizabeth Wahl
• Katarina Wahl, PT
• Bailey Michel Wahler, FNP
• William Jacob Wahlert, PA-C
• Rachel Marie Wainwright
• Waking Valley LLC (Nicholas C. Cuccia, LPCC, LLC)
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5430)

• Certified Registered Nurse Anesthetist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Certified Registered Nurse Anesthetist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; 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.