Individual provider Active NPI

Gwendolyn M Keyt, CRNA

  • Certified Registered Nurse Anesthetist
  • Portland, OR
National Provider Identifier
1043531999
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
201060012CRNA Issued in OR
Practice address
3181 SW Sam Jackson Park Rd
Mailcode Uhs-2
Portland, OR 97239-3011
Phone
(503) 494-7641
Fax
(503) 418-0884
NPI assigned
Jun 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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 201060012CRNA OR Primary

Addresses

Primary practice location

3181 SW Sam Jackson Park Rd
Mailcode Uhs-2
Portland, OR 97239-3011

Mailing address

4314 NE Hassalo St
Portland, OR 97213-1516
Phone (206) 714-6840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000650 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 4486778636 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Anesthesia LLCGroup PAC ID 2860662996, 29 clinicians

Practice addresses (Care Compare)

9701 SW Barnes Rd
Suite 300
Portland, OR 97225-6689
Phone (503) 297-8081

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 12, 2012 Accepting new patients
Oregon Anesthesiology Group PC CurrentSince Oct 1, 2016 Accepting new patients
On-Site Anesthesia Services Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 7, 2015 Accepting new patients
Complete Anesthesia Care LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 26, 2012 Accepting new patients

Locations

707 SW Washington St
Ste 700
Portland, OR 97205

9701 SW Barnes Rd
Ste 300
Portland, OR 97225
Phone (503) 297-8081

1130 NW 22nd Ave
Ste 615
Portland, OR 97210
Phone (503) 229-7137

1130 NW 22nd Ave
Ste 410
Portland, OR 97210
Phone (503) 229-7137

3181 SW Sam Jackson Park Rd
#2
Portland, OR 97239
Phone (503) 494-4910

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

1111 NE 99th Ave
Ste 302
Portland, OR 97220
Phone (503) 963-2707

2480 Liberty St NE
Ste 120
Salem, OR 97301
Phone (503) 363-4355

6464 SW Borland Rd
Ste A3
Tualatin, OR 97062
Phone (503) 292-8614

Organizations & group practices 4

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": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1043531999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 NE HASSALO ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131516",
            "telephone_number": "206-714-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 SW SAM JACKSON PARK RD",
            "address_2": "MAILCODE UHS-2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972393011",
            "telephone_number": "503-494-7641",
            "fax_number": "503-418-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEYT",
        "first_name": "GWENDOLYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201060012CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.