Individual provider Active NPI

Michael Malouf, CRNA

  • Certified Registered Nurse Anesthetist
  • Weston, ID
National Provider Identifier
1912208554
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN-1504 Issued in HI
Practice address
74 S Highway 36
Weston, ID 83286-5000
Phone
(208) 390-7843
NPI assigned
Nov 12, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 2

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

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
North Canyon Medical Center Inc 73 clinicians
Medstream Anesthesia Hawaii LLC 24 clinicians

Practice addresses (Care Compare)

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

67-1125 Mamalaho Hwy
Kamuela, HI 96743-8496
Phone (808) 885-4444

Hospital & facility affiliations

  • North Canyon Medical Center Hospital, Gooding, ID, CCN 131302
  • North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, AK, CA, ID4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20121019000361 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951583236 Reassigns benefits to 1 organization
I20230420002877 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951583236 Reassigns benefits to 1 organization
I20240717004899 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951583236 Reassigns benefits to 1 organization
I20250410001749 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 1951583236 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95002286CAMDAcute Care Nurse Practitioner
598527-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Medstream Anesthesia Hawaii, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2015 Accepting new patients
North Canyon Medical Center Inc. CurrentSince Oct 1, 2025 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Apr 1, 2025 Accepting new patients
Chugach Anesthesia, LLC CurrentSince Apr 1, 2023 Accepting new patients
Sda Services of Ca CurrentSince May 4, 2024 Accepting new patients
New Mexico Anesthesia Specialists LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Anesthesia Relief LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Alaska Spine Center, LLC Past Accepting new patients
Inland Cardiology Associates, P.S. Past Accepting new patients
American Anesthesiology of Syracuse, PC Past Accepting new patients

Locations

1230 Northway Dr
Anchorage, AK 99508
Phone (907) 550-6100

4100 Lake Otis Pkwy
Ste 212
Anchorage, AK 99508
Phone (907) 550-6100

3800 Janes Rd
Arcata, CA 95521
Phone (707) 822-3621

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

14700 28th Ave N
Ste 20
Plymouth, MN 55447
Phone (612) 559-3779

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN-1504 HI Primary
Certified Registered Nurse Anesthetist 367500000X 598527-1 NY

Addresses

NPPES NPI Registry

Primary practice location

74 S Highway 36
Weston, ID 83286-5000

Mailing address

PO Box 2295
Asheville, NC 28802-2295
Phone (828) 398-5244

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 17, 2017.

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1912208554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2295",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288022295",
            "telephone_number": "828-398-5244",
            "fax_number": "828-360-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 S HIGHWAY 36",
            "city": "WESTON",
            "state": "ID",
            "postal_code": "832865000",
            "telephone_number": "208-390-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOUF",
        "first_name": "MICHAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-12",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "HI",
            "license": "APRN-1504",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "598527-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.