Individual provider Active NPI

Kenneth Narayan, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Nellis Afb, NV
National Provider Identifier
1013579507
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
95001185 Issued in CA
Practice address
4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone
(702) 653-2273
NPI assigned
Jul 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 95001185 CA Primary

Addresses

Primary practice location

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220601002302 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800274994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyons Huber ManagementGroup PAC ID 4789093741, 6 clinicians

Practice addresses (Care Compare)

15630 18TH Ave
Clearlake, CA 95422-9336
Phone (707) 994-6486

Hospital & facility affiliations

  • Adventist Health Clearlake Hospital, Clearlake, CA, CCN 051317
  • Adventist Health St Helena Hospital, Saint Helena, CA, CCN 050013
  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301

Merit-based Incentive Payment System (MIPS)

Final score
90.74 of 100Reported as group
Quality
94
Promoting interoperability
92
Improvement activities
40
Cost
65.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95001185CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lyons Huber Management Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2022 Accepting new patients

Locations

15630 18th Ave
Clearlake, CA 95422
Phone (707) 995-5820

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1013579507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARAYAN",
        "first_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-03",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nellis Afb, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.

Verify at the official NPI Registry.