| Robert D Northern Jr, CRNA | |
|
243 Green Valley Rd Ste F, Freedom, CA 95019-3133 | |
| (831) 763-0407 | |
| Not Available |
| Full Name | Robert D Northern Jr |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 36 Years |
| Location | 243 Green Valley Rd Ste F, Freedom, California |
| 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 |
|---|---|---|---|
| 1952442675 | NPI | - | NPPES |
| 273942 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 200560036CRNA (Oregon) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | NA1788 (California) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Watsonville Community Hospital | Watsonville, CA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lifelinc Anesthesia Vi Pc | 0749688000 | 20 |
| Entity Name | Southern Monterey County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114917564 PECOS PAC ID: 7719883461 Enrollment ID: O20050216000803 |
| Entity Name | Monterey Anesthesia Professionals |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073935250 PECOS PAC ID: 6002047164 Enrollment ID: O20140402002486 |
| Entity Name | Amsurg Marin Anesthesia Lp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972929925 PECOS PAC ID: 7214160191 Enrollment ID: O20140603000058 |
| Entity Name | Northern Nursing Anesthesia Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235604299 PECOS PAC ID: 6406195338 Enrollment ID: O20190311002297 |
| Entity Name | Southern Monterey County Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1114917564 PECOS PAC ID: 7719883461 Enrollment ID: O20200521000977 |
| Entity Name | Lifelinc Anesthesia Vi Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487221628 PECOS PAC ID: 0749688000 Enrollment ID: O20211018001772 |
| Entity Name | Maitran Consulting Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003572769 PECOS PAC ID: 2567858764 Enrollment ID: O20220414001359 |
| Mailing Address | Practice Location Address |
|---|---|
| Robert D Northern Jr, CRNA 416b Main St, Salinas, CA 93901-3306 Ph: (831) 800-7887 | Robert D Northern Jr, CRNA 243 Green Valley Rd Ste F, Freedom, CA 95019-3133 Ph: (831) 763-0407 |