Ruben Jesus Perdomo, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2896962 Issued in FL

Practice address

4901 Grande Dr
Pensacola, FL 32504-5935

Phone

(850) 477-7042

Fax

(850) 474-9060

NPI assigned

Jan 25, 2007

Last updated

Dec 14, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ams Anesthetist Services LLCGroup PAC ID 8325298458, 149 clinicians

Capital Anesthesia Solutions of Florida II, LLCGroup PAC ID 7911323720, 327 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ams Anesthetist Services LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1770834426

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Capital Anesthesia Solutions of Florida II, LLC

  • Anesthesiology Physician
  • Naples, FL
  • NPI 1891318481
  Medicare reassignment Care Compare group
• Anesthesia and Pain Consultants PA

  • Specialist
  • Destin, FL
  • NPI 1316986235
  NPD (past)
• Anesthesia Unlimited Inc

  • Anesthesiology Physician
  • Panama City, FL
  • NPI 1871519884
  NPD (past)

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

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1952457939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 GRANDE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045935",
            "telephone_number": "850-477-7042",
            "fax_number": "850-474-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERDOMO",
        "first_name": "RUBEN",
        "middle_name": "JESUS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "2896962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL LICENSE",
            "identifier": "ARNP2896962",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00242573",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "G3834",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "592-10270",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00957902",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Angelo Perciballi, M.D.
• Perdido Bay Dental PA
• Perdido Bay Family Care, LLC
• Perdido Counseling Professionals, Inc.
• Perdido Dental Associates, PA
• Amanda Perdue, APRN, FNP-BC
• Elizabeth Pereira, PT, DPT
• Wendy Su Pereira, NP
• Janeilys Perez-Vazquez, RBT
• Aliyah Anne Perez

• Certified Registered Nurse Anesthetist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.