Individual provider Active NPI

Charles Sotovilla, CRNA

  • Certified Registered Nurse Anesthetist
  • New York, NY
National Provider Identifier
1932685773
Registry record updated Mar 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123658 Issued in NY
Practice address
1468 Madison Ave Dept of
New York, NY 10029-6508
Phone
(212) 241-7473
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 620794 NY
Certified Registered Nurse Anesthetist 367500000X 123658 NY Primary

Addresses

Primary practice location

1468 Madison Ave Dept of
New York, NY 10029-6508

Mailing address

44 Autumn Ave
Brooklyn, NY 11208-1512
Phone (718) 213-3281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190109002999 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800132051 Reassigns benefits to 2 organizations
I20230621003537 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800132051 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Canj Anesthesia LLCGroup PAC ID 6709278740, 75 clinicians
Bay AnesthesiaGroup PAC ID 0446639306, 75 clinicians
Trustees of Columbia University in the City of New YorkGroup PAC ID 8527972546, 2,262 clinicians

Practice addresses (Care Compare)

55 Mdwlands Pkwy
Secaucus, NJ 07094-2977
Phone (917) 681-4963

561 Cranbury Rd
East Brunswick, NJ 08816-5400
Phone (201) 620-3010

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9876

Hospital & facility affiliations

  • New York-Presbyterian Hospital Hospital, New York, NY, CCN 330101
  • Hudson Regional Hospital Hospital, Secaucus, NJ, CCN 310118

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
85.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
123658NYMDClinical Social Worker
620794NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Canj Anesthesia LLC CurrentSince Jun 8, 2023 Accepting new patients
Bay Anesthesia LLC CurrentSince Apr 18, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Feb 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Feb 1, 2023 Accepting new patients
Long Island Anesthesia Physicians LLP CurrentSince Dec 1, 2018 Accepting new patients

Locations

561 Cranbury Rd
East Brunswick, NJ 08816
Phone (201) 620-3010

500 Grand Ave
Ste 3
Englewood, NJ 07631

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

200 Belle Terre Rd
Prt Jefferson, NY 11777
Phone (631) 474-6000

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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 6

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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648252800000",
    "number": "1932685773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 AUTUMN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112081512",
            "telephone_number": "718-213-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 MADISON AVE DEPT OF",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296508",
            "telephone_number": "212-241-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOVILLA",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2022-03-26",
        "certification_date": "2022-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "620794",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "123658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.