Individual provider Active NPI

Kevin Pittman, CRNA

  • Certified Registered Nurse Anesthetist
  • Fort Lauderdale, FL
National Provider Identifier
1023143500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP9210293 Issued in FL
Practice address
1600 South Andrews Ave
Broawrd General Medical Center
Fort Lauderdale, FL 33316
Phone
(954) 355-4400
NPI assigned
Feb 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 ARNP9210293 FL Primary

Addresses

Primary practice location

1600 South Andrews Ave
Broawrd General Medical Center
Fort Lauderdale, FL 33316

Mailing address

3601 W Commercial Blvd Suite 4
Anesco North Broward LLC
Fort Lauderdale, FL 33309
Phone (954) 485-5666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070723000781 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2567563315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5301 N Dixie Hwy
Suite 100
Oakland Park, FL 33334-3447
Phone (954) 939-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St. Lucie Anesthesia Associates, LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2024 Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Jul 1, 2024 Accepting new patients
St Lucie Anesthesia Associates LLC Current Accepting new patients
Anesco Central LLC Past Accepting new patients

Locations

501 Glades Rd
Boca Raton, FL 33432
Phone (561) 362-4400

1801 W Sample Rd
Ste 200
Deerfield Beach, FL 33064
Phone (954) 904-0723

4675 Linton Blvd
Delray Beach, FL 33445
Phone (561) 381-4305

3995 NW Goldenrod Rd
Jensen Beach, FL 34957
Phone (772) 497-0020

16853 NE 2nd Ave
Ste 400
North Miami Beach, FL 33162
Phone (305) 652-2999

5301 N Dixie Hwy
Ste 100
Oakland Park, FL 33334
Phone (954) 771-3334

1800 SE Tiffany Ave
Port St Lucie, FL 34952
Phone (772) 398-1969

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023143500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 W COMMERCIAL BLVD SUITE 4",
            "address_2": "ANESCO NORTH BROWARD LLC",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33309",
            "telephone_number": "954-485-5666",
            "fax_number": "954-484-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SOUTH ANDREWS AVE",
            "address_2": "BROAWRD GENERAL MEDICAL CENTER",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-355-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "KEVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP9210293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.