NPIMap

Organization Active NPI

Elite Anesthesia Associates

  • Certified Registered Nurse Anesthetist
  • Orem, UT
National Provider Identifier
1922627975
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
ELITE ANESTHESIA ASSOCIATES
Practice address
175 N 400 W Ste C10
Orem, UT 84057-1909
Phone
(801) 224-6767
NPI assigned
Apr 9, 2020
Last updated
Oct 28, 2022By the provider in NPPES
Organization subpart
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

Authorized official

Name
Michael Bergeson, CRNANPI 1477068294
Title
Owner
Phone
(804) 335-7421

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary

Addresses

Primary practice location

175 N 400 W Ste C10
Orem, UT 84057-1909

Mailing address

7090 S Union Park Ave Ste 300
Midvale, UT 84047-6041
Phone (801) 836-4323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV, CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210114001879 UT Part B Supplier - Clinic/Group Practice 2668885575 Receives reassigned benefits from 9 practitioners
Practice locations: Lindon, UT; Orem, UT; Salt Lake City, UT; St George, UT
O20230223002297 NV Part B Supplier - Clinic/Group Practice 2668885575 Receives reassigned benefits from 2 practitioners
Practice locations: Las Vegas, NV
O20231004004203 CO Part B Supplier - Clinic/Group Practice 2668885575 Receives reassigned benefits from 1 practitioner
Practice locations: Aurora, CO; Denver, CO; Thornton, CO

National Provider Directory

National Provider Directory

Locations

2210 S Federal Blvd
Unit 1
Denver, CO 80219
Phone (303) 936-5922

161 W 200 N
Ste 105
St George, UT 84770
Phone (435) 216-7063

Practitioners & affiliated clinicians

Practitioners 37

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1922627975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7090 S UNION PARK AVE STE 300",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840476041",
            "telephone_number": "801-836-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N 400 W STE C10",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840571909",
            "telephone_number": "801-224-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ANESTHESIA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "BERGESON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-335-7421",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.