Ruben P Dettman, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

209.023868 Issued in IL

Practice address

1425 N Randall Rd
Elgin, IL 60123-2300

Phone

(630) 456-5593

NPI assigned

Jul 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians

Quantum Anesthesia Services LLCGroup PAC ID 7618100751, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Hospital-Elgin Hospital, Elgin, IL, CCN 140217

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Northstar Anesthesia of Illinois, LLC

  • Anesthesiology Physician
  • Arlington, TX
  • NPI 1962822395

  IL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Quantum Anesthesia Services LLC

  • Certified Registered Nurse Anesthetist
  • Saint Louis, MO
  • NPI 1033546833

  IL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Exhale Sinus PLLC

  • Otolaryngology Physician
  • Schaumburg, IL
  • NPI 1841838109
  Medicare reassignment NPD
• Ear Nose and Throat Family Clinic of Wisconsin SC

  • Otolaryngology Physician
  • Kenosha, WI
  • NPI 1578650164

  IL

  Medicare reassignment NPD
• Midwest Anesthesia Providers S.C

  • Anesthesiology Physician
  • Saint Louis, MO
  • NPI 1295189082

  IL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  NPD
• Lifeline Medical Associates, LLC

  • Obstetrics & Gynecology Physician
  • Florham Park, NJ
  • NPI 1821041617
  NPD (past)

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

• Saint Joseph Hospital - Elgin LLC

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1922846351
  Care Compare affiliation

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1881266971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232300",
            "telephone_number": "630-456-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMAN",
        "first_name": "RUBEN",
        "middle_name": "P",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041431339",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.023868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1425 N Randall Rd",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601232300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdettman318494@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1425 N Randall Rd",
            "city": "Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601232300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nimit Desai, DO
• Parin N Desai, M.D.
• Payal Desai
• Lina Deshpande, MD
• Nicholas James Desmond, DPT
• Tammy A Devries
• Christina Grace Dewar, BSW
• Tracey Dewis, BCBA
• Megan Dewitt
• Dexter Dental 2 LLC

• Certified Registered Nurse Anesthetist in Elgin, IL
• Providers in Elgin, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.