| Benjamin D Weaver, CRNA | |
|
4805 Ne Glisan St, Portland, OR 97213-2933 | |
| (503) 215-1111 | |
| Not Available |
| Full Name | Benjamin D Weaver |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 4805 Ne Glisan St, Portland, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538122734 | NPI | - | NPPES |
| 0181288 | Other | WA | LABOR & INDUSTRY |
| 9640236 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30006644 (Washington) | Primary |
| 163W00000X | Registered Nurse | RN00136294 (Washington) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Portland Medical Center | Portland, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Hospitalist Medicine Physicians Of Washington - Tcs | 6800240102 | 197 |
| Entity Name | Oregon Anesthesiology Group PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477527786 PECOS PAC ID: 3476451659 Enrollment ID: O20031226000058 |
| Entity Name | Juniper Anesthesia Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710400254 PECOS PAC ID: 6901177906 Enrollment ID: O20170809004057 |
| Entity Name | Hospitalist Medicine Physicians of Washington - Tcs |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649816380 PECOS PAC ID: 6800240102 Enrollment ID: O20230920001616 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin D Weaver, CRNA 2752 Montello Ave # 97031, Hood River, OR 97031-1055 Ph: (206) 598-8920 | Benjamin D Weaver, CRNA 4805 Ne Glisan St, Portland, OR 97213-2933 Ph: (503) 215-1111 |
Mr. Daniel Paul Addy, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-1234 |
Austin W Smith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 10123 Se Market St, Portland, OR 97216 Phone: 503-257-2500 |
Magdalena Gregorczyk, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 034-944-9105 Fax: 503-494-8368 |
Mariame Bongo Sanoh, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3455 Sw Us Veterans Hospital Rd, Portland, OR 97239 Phone: 503-494-7725 |
Cecilia Bradford, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4805 Ne Glisan St, Portland, OR 97213 Phone: 503-215-1111 |
Trevor Sawyer, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-7725 |
Ms. Bonnie Helen O'hara, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: Providence St. Vincent Medical Center, 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-3321 |