Justin Richard Snedaker, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN589897 Issued in PA

Practice address

801 W Maple St
Farmington, NM 87401-5630

Phone

(505) 609-2000

NPI assigned

Mar 4, 2010

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 ID

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock Creek Anesthesia Services PLLCGroup PAC ID 1355604299, 6 clinicians

Blue Lakes AnesthesiaGroup PAC ID 1951841303, 8 clinicians

Northstar Anesthesia of Idaho PLLCGroup PAC ID 6204283856, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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 and National Provider Directory roles.

• Blue Lakes Anesthesia

  • Certified Registered Nurse Anesthetist
  • Twin Falls, ID
  • NPI 1073344651

  ID, Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Northstar Anesthesia of Idaho PLLC

  • Anesthesiology Physician
  • Pocatello, ID
  • NPI 1912686882

  ID

  Medicare reassignment Care Compare group NPD
• Rock Creek Anesthesia Services PLLC

  • Anesthesiology Physician
  • Twin Falls, ID
  • NPI 1790284198

  ID

  Medicare reassignment Care Compare group NPD
• Ambulatory Surgery Center of Burley, LLC

  • Ambulatory Surgical Clinic/Center
  • Burley, ID
  • NPI 1992706840

  ID, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Minidoka Memorial Hospital

  • Emergency Care Clinic/Center
  • Rupert, ID
  • NPI 1134333495

  ID, Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362

  ID

  Medicare reassignment
• Twin Falls Anesthesia Associates LLC

  • Anesthesiology Physician
  • Twin Falls, ID
  • NPI 1952683625

  Nurse Anesthetist, Certified Registered

  NPD
• Four Corners Anesthesia, P.a.

  • Anesthesiology Physician
  • Farmington, NM
  • NPI 1093758831

  Nurse Anesthetist, Certified Registered

  NPD (past)
• San Juan Regional Medical Center Inc

  • Pediatrics Physician
  • Farmington, NM
  • NPI 1093800534
  NPD (past)

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1992028088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-326-6400",
            "fax_number": "505-326-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015630",
            "telephone_number": "505-609-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNEDAKER",
        "first_name": "JUSTIN",
        "middle_name": "RICHARD",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-04",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN589897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40929051",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1992028088",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67406203",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634505",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NMAAA1458",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Smith, PA-C
• Tara Colleen Smith, C.N.P.
• Van C Smith, DDS
• Smiths Food & Drug Centers Inc
• Robert Bradford Snapp, RPH
• Tawnee Sneed
• Dawn Kormos Snuggerud, LPCC
• Tyson Snyder, LPCC
• Lindsey L Sorensen
• Jadyn T Sorrelhorse, PTA

• All providers in Farmington, NM
• Certified Registered Nurse Anesthetist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.