Individual provider Active NPI

Nicholas Michael Angelis, CRNA

  • Certified Registered Nurse Anesthetist
  • Pensacola, FL
National Provider Identifier
1871801225
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9271609 Issued in FL
Practice address
4901 Grande Dr
Pensacola, FL 32504-5935
Phone
(850) 477-7042
Fax
(850) 474-9060
NPI assigned
Sep 20, 2010
Last updated
Nov 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 ARNP9271609 FL Primary

Addresses

Primary practice location

4901 Grande Dr
Pensacola, FL 32504-5935

Mailing address

4901 Grande Dr
Pensacola, FL 32504-5935
Phone (850) 477-7042

Other identifiers 4

IdentifierTypeStateIssuer
G00JEOtherFLBLUE CROSS BLUE SHIELD
002764500MedicaidFL
122741MedicaidAL
592-12787OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101026000907 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567655228 Reassigns benefits to 3 organizations
I20170913000744 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567655228 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trans-Ohio Anesthesia, LLCGroup PAC ID 5092979625, 3 clinicians

Practice addresses (Care Compare)

325 Cypress Pkwy
Kissimmee, FL 34759-3326
Phone (954) 939-5000

9225 E Market St
Warren, OH 44484-5517
Phone 33037274702112

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 12, 2022 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Gastroenterology Associates of Pensacola PA CurrentSince Feb 8, 2016 Accepting new patients
Lake Erie Sedation Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 11, 2022 Accepting new patients
Resource Anesthesia Highlands Inc Nurse Anesthetist, Certified Registered CurrentSince Aug 1, 2017 Accepting new patients
BMR Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2020 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Trans-Ohio Anesthesia, LLC CurrentSince Aug 14, 2019 Accepting new patients
Gastroenterology Associates of Pensacola PA CurrentSince Feb 8, 2016 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Apr 1, 2019 Accepting new patients
Ascend Health Center, LLC CurrentSince Mar 1, 2019 Accepting new patients

Locations

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

4585 E Highway 20
Ste 125
Niceville, FL 32578
Phone (850) 426-5191

1851 N 9th Ave
Ste B
Pensacola, FL 32503
Phone (850) 479-4223

4828 N Davis Hwy
Pensacola, FL 32503

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

9400 University Pkwy
Pensacola, FL 32514
Phone (850) 208-6000

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

400 10th St E
Waconia, MN 55387

8185 Washington St
Ste 6
Chagrin Falls, OH 44023
Phone (440) 708-0582

75 Sylvania Dr
Dayton, OH 45440
Phone (937) 320-5050

9000 N Main St
Ste 405
Englewood, OH 45415
Phone (937) 320-5050

1000 S Cleveland Massillon Rd
Ste 1
Fairlawn, OH 44333
Phone (330) 754-4844

1275 N High St
Hillsboro, OH 45133
Phone (937) 393-5503

1611 S Green Rd
Ste 120
South Euclid, OH 44121
Phone (440) 708-0582

9225 E Market St
Warren, OH 44484
Phone (330) 372-7470

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21561/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1871801225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELIS",
        "first_name": "NICHOLAS",
        "middle_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-20",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9271609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "G00JE",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002764500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122741",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "592-12787",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.