Individual provider Active NPI

Micheal Wayne Ellender, CRNA

  • Certified Registered Nurse Anesthetist
  • Lake Charles, LA
National Provider Identifier
1992044309
Registry record updated Feb 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP07167 Issued in LA
Practice address
4150 Nelson Rd Ste A4
Lake Charles, LA 70605-4169
Phone
(337) 540-6900
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2013

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 AP07167 LA Primary

Addresses

Primary practice location

4150 Nelson Rd Ste A4
Lake Charles, LA 70605-4169

Mailing address

4150 Nelson Rd Ste A4
Lake Charles, LA 70605-4169
Phone (337) 540-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130405000294 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032354451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesiology and Pain Consultants LLCGroup PAC ID 3870490402, 48 clinicians

Practice addresses (Care Compare)

4811 Ambassador Caffery Pkwy
Suite 100
Lafayette, LA 70508-7266
Phone (337) 988-5646

Hospital & facility affiliations

  • Lafayette Surgical Specialty Hospital Hospital, Lafayette, LA, CCN 190259
  • Park Place Surgical Hospital Hospital, Lafayette, LA, CCN 190255

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology & Pain Consultants, LLC CurrentSince Nov 1, 2023 Accepting new patients
Lake Charles Anesthesiology, Apmc CurrentSince Feb 1, 2024 Accepting new patients

Locations

1103 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508
Phone (318) 981-3546

1101 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 231-5775

4811 Ambassador Caffery Pkwy
Ste 100
Lafayette, LA 70508
Phone (337) 237-8119

1757 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 310-2832

1701 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-3000

524 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 430-4455

4150 Nelson Rd
Ste 4
Lake Charles, LA 70605
Phone (318) 474-6353

4150 Nelson Rd
Ste A4
Lake Charles, LA 70605
Phone (318) 474-6353

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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 3

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360022400000",
    "number": "1992044309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD STE A4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054169",
            "telephone_number": "337-540-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 NELSON RD STE A4",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054169",
            "telephone_number": "337-540-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENDER",
        "first_name": "MICHEAL",
        "middle_name": "WAYNE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2013-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP07167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; 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.