Individual provider Active NPI

Marie D. Koehler, CRNA

  • Certified Registered Nurse Anesthetist
  • Philadelphia, PA
National Provider Identifier
1164440376
Registry record updated Jul 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN506345L Issued in PA
Practice address
3998 Red Lion Rd
Philadelphia, PA 19114-1436
Phone
(215) 612-4000
Fax
(215) 807-8235
NPI assigned
Jul 17, 2006
Last updated
Jul 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN506345L PA Primary
Certified Registered Nurse Anesthetist 367500000X RN 9360702 FL

Addresses

Primary practice location

3998 Red Lion Rd
Philadelphia, PA 19114-1436

Mailing address

PO Box 8500-6335
Philadelphia, PA 19178-0001
Phone (215) 807-8000

Other identifiers 3

IdentifierTypeStateIssuer
3056444OtherPAAETNA CONTRACT
9495005OtherPACIGNA
430078471OtherPARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131002000212 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7315998762 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

555 SE 5TH Ave
Delray Beach, FL 33483-5212
Phone (954) 939-5000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN 9360702FLMDCertified Registered Nurse Anesthetist
RN506345LPAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
St Lucie Anesthesia Associates LLC CurrentSince Feb 1, 2015 Accepting new patients
St Lucie Anesthesia Associates LLC Current Accepting new patients
St. Lucie Anesthesia Associates, LLC CurrentSince Feb 1, 2015 Accepting new patients
Aria Health Physician Services Past Accepting new patients
MRI Physician Associates, PC Past Accepting new patients
Clearwater Pain Management Associates Past Accepting new patients
Aria Health Physician Services Past Accepting new patients
Greater Florida Anesthesiologists, LLC Past Accepting new patients
Greater Florida Anesthesiologists, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Liberty Anesthesia Associates, P. C. Past Accepting new patients

Locations

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

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

555 SE 5th Ave
Delray Beach, FL 33483
Phone (561) 319-0751

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

460 N State Road 7
Royal Palm Beach, FL 33411
Phone (561) 792-7333

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1164440376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8500-6335",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780001",
            "telephone_number": "215-807-8000",
            "fax_number": "215-807-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141436",
            "telephone_number": "215-612-4000",
            "fax_number": "215-807-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHLER",
        "first_name": "MARIE",
        "middle_name": "D.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN506345L",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN 9360702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA CONTRACT",
            "identifier": "3056444",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9495005",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "430078471",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.