MEDICARE: BOBARA PASTOR CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	1198305	TX
2	367500000X	Certified Registered Nurse Anesthetist	RN-290431	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00438138	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0583328	OTHER	OH	BCMH
2	000000233296	OTHER	OH	UNISON
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	9716100	OTHER	OH	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528260056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBARA PASTOR CRNA

Provider Business Mailing Address
First Line	:	3605 WARRENSVILLE CENTER RD FL 1
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44122-5203
Country	:	US
Telephone Number	:	216-286-6260
Fax Number	:	216-286-6341

Provider Business Practice Location Address
First Line	:	11100 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-844-7330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	12/17/2025

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