THAO NGOC DEBELEN CRNA
NPI 1154693075
Nurse Anesthetist, Certified Registered in Jacksonville, FL
About Thao Ngoc Debelen Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THAO NGOC DEBELEN CRNA (NPI 1154693075) is an individual nurse anesthetist, certified registered in Jacksonville, Florida, licensed in Florida (ARNP9173240) and active in the NPI registry since February 2012. She is affiliated with Mayo Clinic, maintains a secondary practice location in Orange Park, and is a graduate of Other (2011).
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Thao Ngoc Debelen 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.
Medicare Billing Reassignments
4Medicare enrollment records show Thao Debelen reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Jacksonville, FL 32224
- Reassigned Medicare billing, Florida enrollment
- 1,828 clinicians in this Medicare group
Jacksonville, FL 32256
- Reassigned Medicare billing, Florida enrollment
- 121 clinicians in this Medicare group
Orange Park, FL 32003
- Reassigned Medicare billing, Florida enrollment
- 876 clinicians in this Medicare group
Bradenton, FL 34208
- Reassigned Medicare billing, Florida enrollment
- 1,887 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Mayo Clinic
Acute Care Hospitals · Jacksonville, FLPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 32224 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSONVILLE, FL 32224
JACKSONVILLE, FL 32224
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 Thao Debelen's NPI number?
The NPI number for Thao Debelen is 1154693075. It was assigned to this individual provider in the NPPES registry on February 8, 2012.
Where is Thao Debelen located?
Thao Debelen practices at 4500 San Pablo Rd S, Jacksonville, FL 32224. The listed phone number is (904) 953-2000.
What is Thao Debelen's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Thao Debelen enrolled in Medicare?
Yes. Thao Debelen 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.
Which organizations bill Medicare for Thao Debelen's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Thao Debelen reassigns Medicare benefits to 4 organizations: Mayo Clinic Jacksonville (Jacksonville, FL), Jax Anesthesia Providers LLC (Jacksonville, FL), Fleming Island Anesthesia LLC (Orange Park, FL) and Anesthesia Dynamics LLC (Bradenton, FL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thao Debelen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Thao Debelen affiliated with any hospitals?
According to CMS data, Thao Debelen is affiliated with Mayo Clinic.
When was this NPI record last updated?
The NPPES record for Thao Debelen was last updated on October 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Thao Ngoc Debelen, CRNA · NPI 1154693075
Nurse Anesthetist, Certified Registered physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since February 8, 2012.
## Identity
- **NPI:** 1154693075 (Entity type: Individual)
- **Enumerated:** February 8, 2012
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** ARNP9173240 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 4500 SAN PABLO RD S, Jacksonville, FL 32224
- **Phone:** (904) 953-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Mayo Clinic Jacksonville (NPI 1174143986, Jacksonville, FL); Jax Anesthesia Providers LLC (NPI 1245271154, Jacksonville, FL); Fleming Island Anesthesia LLC (NPI 1487945895, Orange Park, FL); Anesthesia Dynamics LLC (NPI 1073001012, Bradenton, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** October 13, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1154693075) · Data from the CMS NPPES public registry.