Active NPI
Kyle Rodgers, CRNA
- Certified Registered Nurse Anesthetist
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 63685
- Practice address
- 6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363 - Phone
- (505) 308-3145
- NPI assigned
- Feb 28, 2014
- Last updated
- Jul 20, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | RN60423007 | WA | |
| Certified Registered Nurse Anesthetist | 367500000X | 63685 | NM | Primary |
Addresses
Primary practice location
6709 Academy Rd NE Ste a
Albuquerque, NM 87109-3363
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420
Other practice location 1
1959 NE Pacific St
Box 356540
Seattle, WA 98195-0001
Phone (206) 543-2470
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | krodgers808224@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR, NM
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
504 Elm St NE
Heart Hospital of New Mexico
Albuquerque, NM 87102-2512
Phone (505) 727-1100
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63685 | NM | MD | Certified Registered Nurse Anesthetist |
| RN60423007 | WA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oregon Anesthesiology Group PC | Current | Accepting new patients | |
| Anesthesia Associates Northwest LLC | Current | Accepting new patients | |
| Bosque Clinic LLC | Current | Accepting new patients | |
| Main Street Anesthesia of New Mexico, LLC | Current | Accepting new patients | |
| Columbia Lutheran Charities | Past | Accepting new patients | |
| Columbia Lutheran Charities | Past | Accepting new patients |
Locations
10501 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 727-2000
504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000
6709 Academy Rd NE
Ste A
Albuquerque, NM 87109
Phone (505) 308-3145
117 E 19th St
Roswell, NM 88201
Phone (505) 727-2000
707 SW Washington St
Ste 700
Portland, OR 97205
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883
6400 SE Lake Rd
Ste 130
Portland, OR 97222
Phone (503) 594-1774
Interoperability endpoints
- krodgers808224@oc.providencedirect.org
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1275010985
-
- Anesthesiology Physician
- Milwaukie, OR
- NPI 1548281751
-
- Anesthesiology Physician
- Portland, OR
- NPI 1477527786
-
dba The Bosque Clinic
- Primary Care Nurse Practitioner
- Rio Rancho, NM
- NPI 1033977780
-
dba Lower Columbia Hospice
- Community Based Hospice Care Agency
- Astoria, OR
- NPI 1023038858
-
dba Columbia Memorial Hospital
- Critical Access Hospital
- Astoria, OR
- NPI 1932814704
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
-
dba Lovelace Women's Hospital
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1982799375
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1393545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1013332998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 50095",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981455095",
"telephone_number": "206-543-6420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6709 ACADEMY RD NE STE A",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871093363",
"telephone_number": "505-308-3145"
}
],
"practiceLocations": [
{
"address_1": "1959 NE Pacific St",
"address_2": "Box 356540",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981950001",
"country_code": "US",
"telephone_number": "206-543-2470",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODGERS",
"first_name": "KYLE",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-28",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "RN60423007",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NM",
"license": "63685",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "krodgers808224@oc.providencedirect.org",
"affiliation": "N",
"address_1": "725 S Wahanna Rd",
"city": "Seaside",
"state": "OR",
"country_code": "US",
"postal_code": "971387735",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.