| Audra C Ricica, CRNA | |
|
5050 N Clinton St, Fort Wayne, IN 46825-5886 | |
| (260) 484-8551 | |
| (260) 482-5060 |
| Full Name | Audra C Ricica |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 27 Years |
| Location | 5050 N Clinton St, Fort Wayne, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790769099 | NPI | - | NPPES |
| 430069360 | Other | OH | RRMC |
| 200979940 | Medicaid | IN | |
| 000000208046 | Other | OH | ANTHEM |
| 2210333 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN-252552 (Ohio) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 28188589A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wood County Hospital | Bowling green, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Surgery One Anesthesia Llc | 8820351463 | 32 |
| Wood County Hospital Assn. | 4284653650 | 11 |
| Entity Name | Surgery One Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144724402 PECOS PAC ID: 8820351463 Enrollment ID: O20180413001005 |
| Mailing Address | Practice Location Address |
|---|---|
| Audra C Ricica, CRNA 5052 N Clinton St, Fort Wayne, IN 46825-5822 Ph: (260) 484-8551 | Audra C Ricica, CRNA 5050 N Clinton St, Fort Wayne, IN 46825-5886 Ph: (260) 484-8551 |
Anthony Dzigbordi, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551 | |
Lisa A Tompa, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5050 N Clinton St, Fort Wayne, IN 46825 Phone: 260-484-8551 Fax: 260-482-5060 | |
Nicole Borem Schickel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5734 Coventry Ln, Fort Wayne, IN 46804 Phone: 260-436-7875 | |
Blair John Walker, RN, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 7950 W Jefferson Blvd, Fort Wayne, IN 46804 Phone: 260-416-3000 | |
Madeline Sikes Brooks, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825 Phone: 260-436-7875 Fax: 260-432-9812 | |
Dr. Jennifer Hager, DNP, MBA, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10315 Dawsons Creek Blvd Ste Ab, Fort Wayne, IN 46825 Phone: 260-436-7875 Fax: 260-432-9812 | |
Lisa Osborne, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5734 Coventry Ln, Fort Wayne, IN 46804 Phone: 260-436-7875 |