ETHAN S HARRIS CRNA
NPI 1629638788
Nurse Anesthetist, Certified Registered in Loves Park, IL

Q: What is Ethan Harris's NPI number?

The NPI number for Ethan Harris is 1629638788. It was assigned to this individual provider in the NPPES registry on June 19, 2019.

Q: What is Ethan Harris's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Ethan Harris was last updated on August 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since June 19, 2019Accepts Medicare Assignment

88.09/100

CMS Quality Rating

2202 HARLEM RD STE 200, LOVES PARK, IL 61111(815) 877-4848(815) 636-6125 Get Directions Write a Review

NPPES record last updated: August 12, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 12, 2019, Jun 20, 2019 (2 updates tracked since 2019).

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About Ethan S Harris Crna NPPES

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

ETHAN S HARRIS CRNA (NPI 1629638788) is an individual nurse anesthetist, certified registered in Loves Park, Illinois, licensed in Illinois (209019805) and active in the NPI registry since June 2019. He is affiliated with Katherine Shaw Bethea Hospital and is a graduate of Other (2019).

NPPES Registry Identity

NPI1629638788

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameETHAN S HARRISCredential: CRNA

Location Address2202 HARLEM RD STE 200Loves Park, IL 61111-2754

Mailing Address2202 Harlem Rd Ste 200Loves Park, IL 61111-2754 · (815) 877-4848 · Fax (815) 636-6125

Phone(815) 877-4848

Fax(815) 636-6125

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateJune 19, 2019

Last NPPES UpdateAugust 12, 20192 updates tracked since enumeration

✔ NPI 1629638788 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 IL · 209019805

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.

2202 HARLEM RD STE 200, Loves Park, IL 61111

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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

Ethan S Harris 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 ID6305175050

PECOS Enrollment IDI20190906000023

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.

Anesthesia for lens surgery 00142

Anesthesia for lens surgery involves administering medication to numb the eye area, ensuring you feel no pain during the procedure. This can be a local anesthetic (numbing only the eye area) or general (where you're asleep). It helps make the surgery comfortable and stress-free.

42 services40 patients

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope 00731

This procedure involves the use of an endoscope, a flexible tube with a light and camera, to examine your esophagus, stomach, or upper small bowel. Anesthesia ensures you are comfortable and pain-free during the procedure.

18 services17 patients

Anesthesia for other procedure on large bowel using an endoscope 00811

Anesthesia for an endoscopic procedure on the large bowel ensures comfort and relaxation during the procedure. You'll be given medication to make you drowsy or asleep, eliminating any discomfort. The medication can be administered through a vein or inhaled.

16 services16 patients

Anesthesia for other procedure on lower leg, ankle, and foot bones 01480

Anesthesia for procedures on lower leg, ankle, and foot bones involves administering medication to block pain and sensation in these areas. This allows doctors to perform necessary treatments or surgeries without causing discomfort. The type of anesthesia used can vary based on the specific procedure.

12 services12 patients

Hospital Affiliations CMS Care Compare 3

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

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140012

Location403 E 1st StDixon, IL 61021 · Lee County

Emergency services Birthing friendly

Fhn Memorial Hospital

Acute Care Hospitals · Freeport, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140160

Location1045 West Stephenson StreetFreeport, IL 61032 · Stephenson County

Emergency services Birthing friendly

Uw Health

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140228

Location1401 East State StreetRockford, IL 61104 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61111 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

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.

88.09/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

Improvement Activities

Other Providers at the Same Location NPPES 5

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

DR. MOLLY MAE KELLY MD

Anesthesiology