Individual provider Active NPI

Miranda Shull, CRNA

  • Certified Registered Nurse Anesthetist
  • Columbus, OH
National Provider Identifier
1902362635
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.019907 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-4200
NPI assigned
Feb 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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 APRN.CRNA.019907 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4200

Other identifiers 1

IdentifierTypeStateIssuer
0353860MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201230001658 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4082942099 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians
Anesthesia Care Consultants IncGroup PAC ID 9032210935, 18 clinicians

Practice addresses (Care Compare)

300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000

3003 Paul Sweet Rd
Santa Cruz, CA 95065-1503
Phone (408) 354-9254

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.53 of 100Reported as group
Quality
87.08
Promoting interoperability
100
Improvement activities
40
Cost
69.51

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
LPCH Medical Group Div of Lucile CurrentSince Dec 23, 2020 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Jun 1, 2022 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Jun 1, 2022 Accepting new patients
Anesthesia Care Consultants Inc CurrentSince Sep 1, 2025 Accepting new patients
Mai Nursing Anesthesia PC CurrentSince Sep 10, 2023 Accepting new patients
Stanford Health Care Current Accepting new patients
Stanford Health Care CurrentSince Dec 23, 2020 Accepting new patients
Stanford Health Care CurrentSince Dec 23, 2020 Accepting new patients
Stanford Hospital and Clinics Past Accepting new patients
Lucile Salter Packard Children'S Hospital at Stanford Past Accepting new patients
Anesthesia Care Consultants Inc Past Accepting new patients

Locations

429 Llewellyn Ave
Campbell, CA 95008
Phone (408) 358-5000

300 Canal St
King City, CA 93930
Phone (831) 385-6000

7999 Gateway Blvd
Ste 200
Newark, CA 94560
Phone (510) 806-2947

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

1700 San Pablo Ave
Ste D
Pinole, CA 94564
Phone (510) 724-9500

104 Saint Matthews Ave
San Mateo, CA 94401
Phone (650) 344-8700

3003 Paul Sweet Rd
Santa Cruz, CA 95065
Phone (831) 462-1607

3540 Mendocino Ave
Ste 200
Santa Rosa, CA 95403
Phone (707) 522-6200

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1902362635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4200",
            "fax_number": "614-722-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULL",
        "first_name": "MIRANDA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-19",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.019907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0353860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.