| Mr Michael D Beredo, CRNA | |
|
1 Guthrie Sq, Sayre, PA 18840-1625 | |
| (570) 888-5858 | |
| (570) 887-4464 |
| Full Name | Mr Michael D Beredo |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 23 Years |
| Location | 1 Guthrie Sq, Sayre, 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 |
|---|---|---|---|
| 1033188990 | NPI | - | NPPES |
| CC8362 | Other | NY | RR MEDICARE GROUP |
| P00379063 | Other | NY | RR MEDICARE PIN |
| 430078581 | Other | PA | RR MEDICARE PIN |
| GU039832 | Other | PA | MEDICARE GROUP |
| CC9269 | Other | PA | RR MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN542206 (Pennsylvania) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | 538854-1 (New York) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Cayuga Medical Center At Ithaca | Ithaca, NY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cayuga Medical Associates Pc | 6709897960 | 245 |
| Entity Name | Guthrie Medical Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134178635 PECOS PAC ID: 6002728656 Enrollment ID: O20031103000220 |
| Entity Name | Schuyler Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760582142 PECOS PAC ID: 3577548262 Enrollment ID: O20040618000324 |
| Entity Name | Cayuga Medical Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679525455 PECOS PAC ID: 6709897960 Enrollment ID: O20060601000199 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Michael D Beredo, CRNA 1 Guthrie Sq, Sayre, PA 18840-1625 Ph: (570) 888-5858 | Mr Michael D Beredo, CRNA 1 Guthrie Sq, Sayre, PA 18840-1625 Ph: (570) 888-5858 |
Mr. Edward G. Johnson, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 | |
Mr. Jeffrey Quinton Owen, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 | |
Cathleen C Mall, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 Fax: 570-882-3007 | |
Joseph Herman Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 | |
Mr. Kevin J. Millar, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 Fax: 570-882-3007 | |
Ms. Pamela Jean Ennis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Guthrie Sq, Sayre, PA 18840 Phone: 570-888-5858 |