Dereck Pettiford, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3280462 Issued in FL

Practice address

3330 SW 33Rd Rd
Ocala, FL 34474-7458

Phone

(352) 873-9311

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solace Anesthesia LLCGroup PAC ID 3072945476, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.4 of 100Reported as individual

Quality

63.65

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles (13 of 14)

Locations

Networks

• Freedom Health HMO Network

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.

• Solace Anesthesia, LLC

  • Certified Registered Nurse Anesthetist
  • Oxford, FL
  • NPI 1962046151

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Ams National LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1316330830

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Associates of Ocala, LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1962808287

  FL

  Medicare reassignment NPD
• Anesthesia Dynamics LLC

  • Anesthesiology Physician
  • Bradenton, FL
  • NPI 1073001012

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Gainesville, FL
  • NPI 1164932901

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Nature Coast Anesthesia Providers, P.a.

  • Certified Registered Nurse Anesthetist
  • Mount Dora, FL
  • NPI 1578557104

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Ocala Endoscopy Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Fort Myers, FL
  • NPI 1386693240

  FL, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Panama City, FL
  • NPI 1487160263

  Nurse Anesthetist, Certified Registered

  NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Kissimmee, FL
  • NPI 1902478431
  NPD
• Advanced Surgery Center of Oxford

  • Ambulatory Surgical Clinic/Center
  • Oxford, FL
  • NPI 1033760723
  NPD (past)
• Anesthesia Care Team, Inc.

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1457425571
  NPD (past)
• Ft. Walton Beach Anesthesia Services LLC

  • Anesthesiology Physician
  • Ft. Walton Beach, FL
  • NPI 1245443829
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972677367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8235 SW 72ND PL",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326088425",
            "telephone_number": "352-380-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 SW 33RD RD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344747458",
            "telephone_number": "352-873-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIFORD",
        "first_name": "DERECK",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "3280462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Eric Peterzell, D.O.
• Violet Petrena
• Ahron J Petrillo, DO
• Paul Edward Petsche, D.M.D., M.S.
• Kenneth James Pettengill, R.PH.
• Forrest Petty
• Jason Pfaffly, M.D.
• Raymond Pfriender
• Duc Huong Trung Phan
• Laura Lin Phan, PHARMD

• All providers in Ocala, FL
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.