NPIMap

Individual provider Active NPI

Robert David Pugh, CRNA

  • Certified Registered Nurse Anesthetist
  • Orem, UT
National Provider Identifier
1912500745
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
202211571CRNA Issued in OR
Practice address
775 E 200 N
Orem, UT 84097-4953
Phone
(801) 633-5416
NPI assigned
Nov 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 5494787-3102 UT
Critical Care Medicine Registered Nurse 163WC0200X 310189 NC
Certified Registered Nurse Anesthetist 367500000X 6543 NC
Certified Registered Nurse Anesthetist 367500000X 0000000-0000 UT
Certified Registered Nurse Anesthetist 367500000X 202211571CRNA OR Primary

Addresses

Primary practice location

775 E 200 N
Orem, UT 84097-4953

Mailing address

775 E 200 N
Orem, UT 84097-4953
Phone (801) 633-5416

Other practice location 1

1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

Other identifiers 1

IdentifierTypeStateIssuer
0000000000OtherNONE

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL referral
Direct Messaging Address rpugh243178@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210212001226 UT Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052726692 Reassigns benefits to 1 organization
I20220815003631 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052726692 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.77 of 100Reported as group
Quality
88.09
Promoting interoperability
100
Improvement activities
40
Cost
84.48

Merit-based Incentive Payment System (MIPS)

Final score
94.37 of 100Reported as group
Quality
92.31
Promoting interoperability
100
Improvement activities
40
Cost
80.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5494787-3102UTMDRegistered Nurse
310189NCMDCritical Care Medicine Registered Nurse
6543NCMDCertified Registered Nurse Anesthetist
202211571CRNAORMDCertified Registered Nurse Anesthetist
0000000-0000UTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Aug 8, 2022 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Mid-Valley Healthcare, Inc. CurrentSince Aug 8, 2022 Accepting new patients
Salem Health Current Accepting new patients
Albany General Hospital Current Accepting new patients
NPH Anesthesia of Utah, LLC CurrentSince Nov 1, 2021 Accepting new patients
Albany General Hospital CurrentSince Aug 8, 2022 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Aug 8, 2022 Accepting new patients
Salem Health CurrentSince Feb 2, 2023 Accepting new patients
Salem Health CurrentSince Feb 2, 2023 Accepting new patients

Locations

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

2221 Lakeside Blvd
Ste 600
Richardson, TX 75082
Phone (469) 998-7450

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

331 N 400 W
Orem, UT 84057
Phone (801) 224-4080

5475 S 500 E
South Ogden, UT 84405
Phone (801) 479-2111

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 10

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 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1912500745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 E 200 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974953",
            "telephone_number": "801-633-5416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 E 200 N",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840974953",
            "telephone_number": "801-633-5416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 6th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211916",
            "country_code": "US",
            "telephone_number": "541-812-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PUGH",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "5494787-3102",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "NC",
            "license": "310189",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6543",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "UT",
            "license": "0000000-0000",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "202211571CRNA",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "0000000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "referral",
            "affiliation": "N",
            "address_1": "1635 Fountain Vw",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rpugh243178@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.