| Michael C Loomis, CRNA | |
|
7918 Main Street, Suite 204, Fogelsville, PA 18051-0488 | |
| (610) 366-9536 | |
| (610) 366-9538 |
| Full Name | Michael C Loomis |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 39 Years |
| Location | 7918 Main Street, Fogelsville, Pennsylvania |
| 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 |
|---|---|---|---|
| 1811993769 | NPI | - | NPPES |
| 0019709940001 | Medicaid | PA | |
| 0019709940003 | Medicaid | PA | |
| 1553210 | Other | PA | GATEWAY |
| 11803037 | Other | PA | CAQH |
| 76114 | Other | PA | GEISINGER |
| 50014783 | Other | PA | CAPITAL ADVANTAGE |
| 7951477 | Other | PA | AETNA |
| 1406648 | Other | PA | HIGHMARK |
| 2094350000 | Other | PA | IBC |
| 1406648 | Other | PA | FIRST PRIORITY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN254017L (Pennsylvania) | Primary |
| 163W00000X | Registered Nurse | RN-254017-L (Pennsylvania) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lehigh Valley Hospital | Allentown, PA | Hospital |
| Surgical Institute Of Reading | Wyomissing, PA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Professional Anesthesia Services Of North America Pc | 1658698824 | 44 |
| Lehigh Valley Physician Group | 3072425123 | 2138 |
| Entity Name | Lehigh Valley Anesthesia Services, P. C. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730174731 PECOS PAC ID: 8820992183 Enrollment ID: O20031120000076 |
| Entity Name | Lehigh Valley Physician Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457309650 PECOS PAC ID: 3072425123 Enrollment ID: O20040227000335 |
| Entity Name | Professional Anesthesia Services Of North America Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972994820 PECOS PAC ID: 1658698824 Enrollment ID: O20150327000075 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael C Loomis, CRNA 7918 Main St, Suite 204, Fogelsville, PA 18051-1744 Ph: (610) 366-9536 | Michael C Loomis, CRNA 7918 Main Street, Suite 204, Fogelsville, PA 18051-0488 Ph: (610) 366-9536 |