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CARLY PROVAN CRNA
NPI 1003675992
Nurse Anesthetist, Certified Registered in Bradenton, FL

Active since March 14, 2024Accepts Medicare Assignment
8000 STATE ROAD 64 E, BRADENTON, FL 34212(941) 792-1404 Get Directions Write a Review

NPPES record last updated: March 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Carly Provan Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARLY PROVAN CRNA (NPI 1003675992) is an individual nurse anesthetist, certified registered in Bradenton, Florida, licensed in Florida (RN9514153) and active in the NPI registry since March 2024. She is affiliated with Hca Florida Blake Hospital and is a graduate of University Of South Florida College Of Medicine (2024).

NPPES Registry Identity

NPI1003675992
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameCARLY PROVANCredential: CRNA
Location Address8000 STATE ROAD 64 EBradenton, FL 34212-7703
Mailing Address12912 Usf Health DriveTampa, FL 33612
Phone(941) 792-1404
Sole ProprietorNo
Medical School CMSUniversity Of South Florida College Of MedicineGraduated 2024
Enumeration DateMarch 14, 2024
NPPES CertifiedMarch 13, 2024
✔ NPI 1003675992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in FL · RN9514153
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
8000 STATE ROAD 64 E, Bradenton, FL 34212
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carly Provan Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335688944
PECOS Enrollment IDI20240827004297

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Hca Florida Blake Hospital

Acute Care Hospitals · Bradenton, FL
1/5 CMS rating
OwnershipProprietary
CMS Certification Number100213
Location2020 59th St WBradenton, FL 34209 · Manatee County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 34212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$70.04 typical visit price
range $17.57 – $139.16
Typical copayment $17.51 (range $4.39 – $34.79)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH MAGIONCALDA
Physician Assistant
8000 STATE ROAD 64 E
BRADENTON, FL 34212
Manatee County (941) 792-1404
GABRIELLE LEVY
Occupational Therapist
8000 STATE ROAD 64 E
BRADENTON, FL 34212
Manatee County (941) 792-1404
JASON R WOLF PA
Physician Assistant (Surgical)
8000 STATE ROAD 64 E
BRADENTON, FL 34212
Manatee County (941) 792-1404
COASTAL ORTHOPEDICS AND SPORTS MEDICINE OF SOUTHWEST FLORIDA P.A.
Physical Therapist
8000 STATE ROAD 64 E
BRADENTON, FL 34212
Manatee County (941) 792-1404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Provan's NPI number?

The NPI number for Carly Provan is 1003675992. It was assigned to this individual provider in the NPPES registry on March 14, 2024.

Where is Carly Provan located?

Carly Provan practices at 8000 State Road 64 E, Bradenton, FL 34212. The listed phone number is (941) 792-1404.

What is Carly Provan's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Carly Provan enrolled in Medicare?

Yes. Carly Provan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Carly Provan affiliated with any hospitals?

According to CMS data, Carly Provan is affiliated with Hca Florida Blake Hospital.

When was this NPI record last updated?

The NPPES record for Carly Provan was last updated on March 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.