Individual provider Active NPI

Kevin Korenkiewicz, CRNA

  • Certified Registered Nurse Anesthetist
  • Lewiston, ME
National Provider Identifier
1124416045
Registry record updated Dec 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA143066 Issued in ME
Practice address
300 Main St
Lewiston, ME 04240-7027
Phone
(207) 795-0111
NPI assigned
Dec 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2014

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 RNA143066 ME Primary

Addresses

Primary practice location

300 Main St
Lewiston, ME 04240-7027

Mailing address

300 Main St
Lewiston, ME 04240-7027
Phone (207) 795-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150306000374 ME Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557687761 Reassigns benefits to 5 organizations
I20220623002430 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1557687761 Reassigns benefits to 1 organization

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
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

Hospital & facility affiliations

  • Central Maine Medical Center Hospital, Lewiston, ME, CCN 200024

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
66.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RNA143066MEMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Rumford Hospital CurrentSince Jul 6, 2023 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 15, 2022 Accepting new patients
Bridgton Hospital CurrentSince Jul 1, 2020 Accepting new patients
Central Maine Medical Center CurrentSince Dec 22, 2014 Accepting new patients
Central Maine Medical Center CurrentSince Dec 22, 2014 Accepting new patients
Bridgton Hospital CurrentSince Jul 1, 2020 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jun 15, 2022 Accepting new patients
Rumford Hospital CurrentSince Jul 6, 2023 Accepting new patients

Locations

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

364 Main St
Lewiston, ME 04240
Phone (207) 795-5646

175 Fore River Pkwy
Portland, ME 04102
Phone (207) 553-6105

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 8

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 1

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": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419897600000",
    "number": "1124416045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORENKIEWICZ",
        "first_name": "KEVIN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-30",
        "last_updated": "2014-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "RNA143066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2014; 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.