Amy D Kosanke, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN138246 Issued in AZ

Practice address

101 The City Dr S
Orange, CA 92868-3201

Phone

(714) 456-5261

NPI assigned

Apr 21, 2006

Last updated

Jan 27, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Amy D Fleetwood Former name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Metro-West Anesthesia Group Inc

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1245427335

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Mid-West Anesthesia Partners, LLC

  • Anesthesiology Physician
  • Chesterfield, MO
  • NPI 1851254304
  NPD (past)

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264550400000",
    "number": "1215993985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 THE CITY DR S",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683201",
            "telephone_number": "714-456-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSANKE",
        "first_name": "AMY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2010-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AZ",
            "license": "RN138246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00321421",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084271",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FLEETWOOD",
            "middle_name": "D",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Richard Korczynski, DO
• Joseph Eric Koressel, MD
• Michael Kornbluth
• Elliott Kornhauser, MD
• Alicia Moriah Kort, M.S. ED
• Lauren Heather Kosik
• Aaron Michael Kosins, M.D., M.B.A.
• Ryan Koster
• Maureen Kotecki, CRNA
• Vinod Kumar Kothapa, M.D.

• Certified Registered Nurse Anesthetist in Orange, CA
• Providers in Orange, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.