Shane Verl Theobald, CRNA in Vernal, UT - Medicare Certified Registered Nurse Anesthetist (crna)

Shane Verl Theobald, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Vernal, Utah. He graduated from nursing school in 2007 and has 17 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Mountain View Anesthesia Lc and his current practice location is 151 W 200 N, Vernal, Utah. You can reach out to his office (for appointments etc.) via phone at (435) 781-1519.

Shane Verl Theobald is licensed to practice in Utah (license number 4938276-4406) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1174783492.

Contact Information

	Shane Verl Theobald, CRNA
	151 W 200 N, Vernal, UT 84078-1907
	(435) 781-1519
	(435) 781-1519

Map and Direction

Provider's Profile

Full Name	Shane Verl Theobald
Gender	Male
Speciality	Certified Registered Nurse Anesthetist (crna)
Experience	17 Years
Location	151 W 200 N, Vernal, Utah
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Shane Verl Theobald graduated from nursing school in 2007

NPI Data:

NPI Number: 1174783492
Provider Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008

Medicare PECOS Information:

PECOS PAC ID: 9234289737
Enrollment ID: I20090603000570

Medical Identifiers

Medical identifiers for Shane Verl Theobald such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174783492	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	4938276-4406 (Utah)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Timpanogos Regional Hospital	Orem, UT	Hospital
Mountain View Hospital	Payson, UT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mountain View Anesthesia Lc	5991604829	21

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shane Verl Theobald allows following entities to bill medicare on his behalf.

Entity Name	Mountain View Anesthesia Lc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043249840 PECOS PAC ID: 5991604829 Enrollment ID: O20040108000626

Entity Name	Riverwoods Anesthesia Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821290883 PECOS PAC ID: 0547217366 Enrollment ID: O20050405000096

Entity Name	Mt Nebo Anesthesia Associates Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053321729 PECOS PAC ID: 3577586932 Enrollment ID: O20060111000831

Entity Name	Sevier Valley Anesthesia Group Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1487895462 PECOS PAC ID: 5991855389 Enrollment ID: O20090605000031

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shane Verl Theobald is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shane Verl Theobald, CRNA Po Box 790164, Vernal, UT 84079-0164 Ph: (435) 781-1519	Shane Verl Theobald, CRNA 151 W 200 N, Vernal, UT 84078-1907 Ph: (435) 781-1519

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Vernal, UT

Mr. Brett Wallace Bulloch, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3342
Pauline Frome, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3021 E 5000 S, Vernal, UT 84078 Phone: 435-790-1877
Mr. Michael Arthur Hartman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3352 Fax: 435-781-6893
Mr. Dee Lewis Bambrough, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 151 W 200 N, Vernal, UT 84078 Phone: 435-789-3342 Fax: 435-781-6893
Edwin Bulloch, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 150 W 100 N, Vernal, UT 84078 Phone: 207-659-8810
Dustin Todd Bradley, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 808 W 300 N, Vernal, UT 84078 Phone: 435-828-2541

Shane Verl Theobald, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Vernal, UT