Kathryn Clark Dearborn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

615852-1 Issued in NY

Practice address

2233 State Route 86
Saranac Lake, NY 12983-5644

Phone

(581) 891-4141

Fax

(404) 941-1282

NPI assigned

Oct 18, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Anesthesia of New York, P.C.Group PAC ID 7719041102, 50 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adirondack Medical Center - Saranac Lake Hospital, Saranac Lake, NY, CCN 330079

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 and National Provider Directory roles.

• Premier Anesthesia of New York, P.C.

  • Anesthesiology Physician
  • Saranac Lake, NY
  • NPI 1063658961

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1699709576
  Care Compare affiliation
• Adirondack Medical Center

  • General Acute Care Hospital
  • Saranac Lake, NY
  • NPI 1851601108
  Care Compare affiliation

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

{
    "created_epoch": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1255616629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 E ELIZABETH ST",
            "address_2": "SUITE 1",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244000",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 STATE ROUTE 86",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129835644",
            "telephone_number": "581-891-4141",
            "fax_number": "404-941-1282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1236 E Elizabeth St",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805244000",
            "country_code": "US",
            "telephone_number": "970-224-2985",
            "fax_number": "970-472-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARBORN",
        "first_name": "KATHRYN",
        "middle_name": "CLARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "CRA-100084",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NY",
            "license": "615852-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80574823",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO MEDICARE",
            "identifier": "COAAA4235",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01080610",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Cottom, PHARM. D.
• Virginia Lee Cuttaia, RN
• Tomas Julius Cyvas
• Timothy Czelusniak Serviss, CASAC
• Heather L Damour, RPH
• John White Decker, M.D.
• Sheila Decker
• Monica Dederick
• Jessica Defuria
• Diane Barbara Delahant, MS, OTR/L

• Certified Registered Nurse Anesthetist in Saranac Lake, NY
• Providers in Saranac Lake, NY by specialty
• Certified Registered Nurse Anesthetist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.