Individual provider Active NPI

Thomas John Olejniczak, CRNA

  • Certified Registered Nurse Anesthetist
  • Dunkirk, NY
National Provider Identifier
1184665382
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3311011 Issued in NY
Practice address
529 Central Ave
Brooks Memorial Hospital
Dunkirk, NY 14048
Phone
(716) 366-1111
Fax
(716) 363-7288
NPI assigned
Jun 9, 2006
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 3311011 NY Primary

Addresses

Primary practice location

529 Central Ave
Brooks Memorial Hospital
Dunkirk, NY 14048

Mailing address

4185 Seneca Street
Suite 11
West Seneca, NY 14224
Phone (716) 674-8189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3311011NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Parkside Medical Anesthesia Associates Nurse Anesthetist, Certified Registered Past Accepting new patients

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184665382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4185 SENECA STREET",
            "address_2": "SUITE 11",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "14224",
            "telephone_number": "716-674-8189",
            "fax_number": "716-712-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 CENTRAL AVE",
            "address_2": "BROOKS MEMORIAL HOSPITAL",
            "city": "DUNKIRK",
            "state": "NY",
            "postal_code": "14048",
            "telephone_number": "716-366-1111",
            "fax_number": "716-363-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLEJNICZAK",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "3311011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunkirk, NY

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.