Individual provider Active NPI

Margaret Moore Faenza, CRNA, RN, BSN

  • Certified Registered Nurse Anesthetist
  • Jacksonville, FL
National Provider Identifier
1992157630
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11003386 Issued in FL
Practice address
4500 San Pablo Rd S
Jacksonville, FL 32224
Phone
(904) 953-2000
NPI assigned
Jul 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN204230 GA
Certified Registered Nurse Anesthetist 367500000X RN204230 GA
Certified Registered Nurse Anesthetist 367500000X APRN11003386 FL Primary

Addresses

Primary practice location

4500 San Pablo Rd S
Jacksonville, FL 32224

Mailing address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Other practice location 1

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Other practice location 2

4700 Waters Ave
Savannah, GA 31404-6220
Phone (912) 350-8000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mfaenza623994@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160908001283 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860788494 Reassigns benefits to 3 organizations
I20191015000652 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860788494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic JacksonvilleGroup PAC ID 5698689297, 1,595 clinicians

Practice addresses (Care Compare)

4500 San Pablo Rd S
Jacksonville, FL 32224-1865
Phone (904) 953-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Certified Registered Nurse, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2018 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Jul 29, 2021 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Sep 23, 2019 Accepting new patients
Anesthesia Consultants of Savannah, PC CurrentSince Apr 1, 2017 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Sep 23, 2019 Accepting new patients

Locations

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

3100 Kemble Ave
Brunswick, GA 31520
Phone (880) 233-2570

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

Interoperability endpoints

  • Direct secure messaging: mfaenza623994@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1992157630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Waters Ave",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314046220",
            "country_code": "US",
            "telephone_number": "912-350-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAENZA",
        "first_name": "MARGARET",
        "middle_name": "MOORE",
        "name_prefix": "Ms.",
        "credential": "CRNA, RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN204230",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN204230",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11003386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfaenza623994@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.