Individual provider Active NPI

Jason Anthony Reddingius, CRNA

  • Certified Registered Nurse Anesthetist
  • Riverside, CA
National Provider Identifier
1972888774
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4114 Issued in CA
Practice address
16643 Rocky Creek Dr
Riverside, CA 92503-6545
Phone
(951) 231-8105
NPI assigned
Oct 13, 2011
Last updated
Oct 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4114 CA Primary

Addresses

Primary practice location

16643 Rocky Creek Dr
Riverside, CA 92503-6545

Mailing address

16643 Rocky Creek Dr
Riverside, CA 92503-6545
Phone (951) 231-8105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140129001075 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9830328566 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Raelle Anesthesia IncGroup PAC ID 8123260874, 11 clinicians

Practice addresses (Care Compare)

11234 Anderson St
Loma Linda, CA 92354-2804

11370 Anderson St
Loma Linda, CA 92354-3450

26780 Barton Rd
Redlands, CA 92373-4308
Phone (909) 558-5174

67555 E Palm Canyon Dr
Suite 117And118
Cathedral City, CA 92234-5467
Phone (760) 656-6111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4114CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
KND Development 59, LLC CurrentSince Jun 16, 2018 Accepting new patients
KND Development 59 LLC CurrentSince Jun 16, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Raelle Anesthesia Inc Nurse Anesthetist, Certified Registered CurrentSince May 15, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Dec 7, 2016 Accepting new patients
KND Development 59 LLC Current Accepting new patients
Golden Springs Surgical Center CurrentSince May 15, 2017 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients

Locations

67555 E Palm Canyon Dr
Ste 117118
Cathedral City, CA 92234
Phone (760) 656-6111

67555 E Palm Canyon Dr
Ste 117
Cathedral City, CA 92234

1900 E Washington St
Colton, CA 92324
Phone (909) 825-3425

12828 Harbor Blvd
#120
Garden Grove, CA 92840
Phone (714) 336-0429

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

6185 Magnolia Ave
Riverside, CA 92506
Phone (951) 215-1442

10694 Magnolia Ave
Riverside, CA 92505
Phone (951) 335-5250

4500 Brockton Ave
#100
Riverside, CA 92501
Phone (714) 336-0429

1003 E Brier Dr
Ste 170
Sn Bernrdno, CA 92408
Phone (909) 370-2190

4201 Torrance Blvd
Ste 590
Torrance, CA 90503
Phone (310) 540-0300

Organizations & group practices 9

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.

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": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1972888774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16643 ROCKY CREEK DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925036545",
            "telephone_number": "951-231-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16643 ROCKY CREEK DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925036545",
            "telephone_number": "951-231-8105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDDINGIUS",
        "first_name": "JASON",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-13",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "4114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.