Individual provider Active NPI

Kyle Smith, CRNA

  • Certified Registered Nurse Anesthetist
  • Austin, TX
National Provider Identifier
1134572027
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP131134 Issued in TX
Practice address
3705 Medical Pkwy
Suite 570
Austin, TX 78705
Phone
(512) 454-2554
NPI assigned
Jul 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 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 AP131134 TX Primary

Addresses

Primary practice location

3705 Medical Pkwy
Suite 570
Austin, TX 78705

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

3705 Medical Pkwy
Suite 570
Austin, TX 78705
Phone (512) 454-2554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606002386 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648564856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Duke University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Practice addresses (Care Compare)

74 B Centennial Loop
Suite 100
Eugene, OR 97401-7919
Phone (541) 780-6654

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP131134TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates Northwest LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

74B Centennial Loop
Ste 100
Eugene, OR 97401
Phone (541) 686-3791

120 NW 14th Ave
Ste 200
Portland, OR 97209
Phone (503) 771-1883

2435 NW Kline St
Roseburg, OR 97471
Phone (541) 672-2020

1330 Commercial St SE
Salem, OR 97302
Phone (503) 763-1973

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.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1134572027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY",
            "address_2": "SUITE 570",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78705",
            "telephone_number": "512-454-2554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3705 Medical Pkwy",
            "address_2": "SUITE 570",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "78705",
            "country_code": "US",
            "telephone_number": "512-454-2554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-15",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP131134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.