| Brent Riva, CRNA | |
|
701 N 1st St, Anesthesia Dept, Springfield, IL 62781-0001 | |
| (217) 788-3755 | |
| (217) 788-7071 |
| Full Name | Brent Riva |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 11 Years |
| Location | 701 N 1st St, Springfield, Illinois |
| 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 |
|---|---|---|---|
| 1902265754 | NPI | - | NPPES |
| 107945 | Other | NBCRNA CERTIFICATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209013837 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Medical Center | Springfield, IL | Hospital |
| Taylorville Memorial Hospital | Taylorville, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Taylorville Memorial Hospital | 8022914704 | 13 |
| Memorial Medical Center | 7315835949 | 131 |
| Entity Name | Memorial Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1255393112 PECOS PAC ID: 7315835949 Enrollment ID: O20040713000579 |
| Entity Name | Abraham Lincoln Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558586180 PECOS PAC ID: 9436040573 Enrollment ID: O20101123001008 |
| Entity Name | Taylorville Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1144292020 PECOS PAC ID: 8022914704 Enrollment ID: O20140109001280 |
| Entity Name | Abraham Lincoln Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1154329753 PECOS PAC ID: 9436040573 Enrollment ID: O20191108001891 |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Riva, CRNA 701 N 1st St, Anesthesia Dept, Springfield, IL 62781-0001 Ph: (217) 788-3755 | Brent Riva, CRNA 701 N 1st St, Anesthesia Dept, Springfield, IL 62781-0001 Ph: (217) 788-3755 |
Douglas Mcdonald Childs, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62704 Phone: 217-525-5643 Fax: 217-544-2521 |
Carol A Gorden, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071 |
Ann R Larson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 701 N 1st St, Anesthesia Department, Springfield, IL 62781 Phone: 217-788-3754 Fax: 217-788-7071 |
Jenna Younker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62702 Phone: 217-525-5643 Fax: 217-544-2521 |
Kelsey A Wallace, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 701 N 1st St, Springfield, IL 62781 Phone: 217-788-3000 |
Stephanie Weitekamp, Nurse Anesthetist - CR Medicare: May Accept Medicare Assignments Practice Location: 800 E Carpenter St, Springfield, IL 62769 Phone: 217-544-6464 |
Delores A Gallo, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1025 S 6th St, Springfield, IL 62703 Phone: 217-528-7541 |