Individual provider Active NPI

Karen Elizabeth Polechetti, CRNA

  • Certified Registered Nurse Anesthetist
  • Medina, NY
National Provider Identifier
1245317247
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
378764-1 Issued in NY
Practice address
534 Main St
Medina, NY 14103-1436
Phone
(585) 798-3992
Fax
(585) 798-3865
NPI assigned
Nov 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 378764-1 NY Primary

Addresses

Primary practice location

534 Main St
Medina, NY 14103-1436

Mailing address

555 Pine St
Lockport, NY 14094-5547
Phone (716) 434-1979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070412000291 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 0648375105 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Lakes Surgical Associates, P.C.Group PAC ID 4486738929, 5 clinicians

Practice addresses (Care Compare)

160 E Ave
Lockport, NY 14094-3835
Phone (716) 434-6141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
378764-1NYMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Endoscopy Center of Western New York LLC CurrentSince Mar 26, 2021 Accepting new patients
North American Partners in Anesthesia LLP CurrentSince May 1, 2021 Accepting new patients
Endoscopy Center of Western New York LLC CurrentSince Jul 20, 2026 Accepting new patients
Andrew J. Siedlecki, M.D., PC Past Accepting new patients
Endoscopy Center of Niagara, LLC PastSince Apr 26, 2020 Accepting new patients
Eye Health Associates of Western New York PC Past Accepting new patients

Locations

7 Southwoods Blvd
Ste 4
Albany, NY 12211

3122 Union St
Ste 1B
Flushing, NY 11354
Phone (718) 968-7171

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

6930 Williams Rd
Ste 3010
Niagara Falls, NY 14304
Phone (716) 284-3264

250 Windward Dr
Ste 140
Orchard Park, NY 14127
Phone (716) 332-1000

60 Maple Rd
#2
Williamsville, NY 14221
Phone (716) 332-1000

Organizations & group practices 9

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245317247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 PINE ST",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945547",
            "telephone_number": "716-434-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 MAIN ST",
            "city": "MEDINA",
            "state": "NY",
            "postal_code": "141031436",
            "telephone_number": "585-798-3992",
            "fax_number": "585-798-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLECHETTI",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "378764-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medina, 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.
  • 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.