Individual provider Active NPI

Gabriella Sentelik

  • Certified Registered Nurse Anesthetist
  • Dawsonville, GA
National Provider Identifier
1962082057
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3356 Issued in HI
Practice address
425 Night Fire Dr
Dawsonville, GA 30534-0717
Phone
(770) 856-6867
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 218671 TN
Certified Registered Nurse Anesthetist 367500000X 3356 HI Primary

Addresses

Primary practice location

425 Night Fire Dr
Dawsonville, GA 30534-0717

Mailing address

425 Night Fire Dr
Dawsonville, GA 30534-0717

Other identifiers 1

IdentifierTypeStateIssuer
1962082057MedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL gsentelik@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211229000937 HI Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698166627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Anesthesia IncGroup PAC ID 1951596329, 108 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2402
Phone (808) 691-1000

Hospital & facility affiliations

  • The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218671TNMDCritical Care Medicine Registered Nurse
3356HIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Anesthesia, Inc CurrentSince Nov 1, 2021 Accepting new patients

Locations

321 N Kuakini St
Ste 306
Honolulu, HI 96817
Phone (808) 545-1557

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

Organizations & group practices 1

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 1

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1962082057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 NIGHT FIRE DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305340717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NIGHT FIRE DR",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305340717",
            "telephone_number": "770-856-6867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENTELIK",
        "first_name": "GABRIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-10-20",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "218671",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "HI",
            "license": "3356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962082057",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "gsentelik@gmail.com",
            "affiliation": "N",
            "address_1": "425 Night Fire Dr",
            "city": "Dawsonville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305340717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dawsonville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.